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It is sometimes crucial to figure out how to tackle performance management successfully. As such it is very important to strategic planning. This implies that strategic planning and performance management are key for any successful business organization all over the globe. The management performance is normally defined in the light of human resources. However, the definition can be broadened to encompass a number of outcomes of the whole business enterprise (Müller, & Friedli, 2015).
The individual performance of each and every employee in any business organization counts to a larger extent to the performance of that business organization. It is also important to consider the fact that the performance of that business organization also counts to the performance of the workforce of the organization. The incorporation of the two perspectives within the strategic management planning framework gives the most important opportunity for the prosperity of the company.
One’s planning process and strategic plan is crucial tools needed to deliver the required performance management. As such the two define the required changes that would impact positively to the key indicators. They also positively affect the key answers as to why changes are critical.
When, there, is no clarity as far as strategy is concerned, the organizational units will essentially develop their agenda alone, there will, therefore, be unconfused, uncoordinated efforts to make things better and the effect as far as the performance is concerned will be diluted dramatically (Müller, & Friedli, 2015). In a nutshell, one’s strategic plan defines why as well as how one would attain one’s goals of performance management.
This paper illustrates how performance management plan, process as well as steps involved are crucial in the performance of a company. It encompasses the analysis of a company’s performance management and now this impacts the success of the company. It is indeed the manifestation of how performance management, plan, and process are crucial, in the business organization.
How Strategic Performance Management Processes Are Affected by Learning and Management Strategies.
Strategic management affects the processes of strategic performance management in many ways. It is, therefore, imperative to know that the system performance, aligning the objectives as well as managing the employees of a given company to propel delivery of such company greatly. They facilitate operational goals as well as the strategic goals as stipulated by the company.
As such, studies show that there is intermediate and clear correlation between applying management of performance programs or software as well as business that is improved and the results of the business organization. The impact of the system of performance management in the public sectors differs from positive to negative (De, 2013).
As a result, this recommends that differences in the performance management system features and the settings in which they get executed to play a role that is very important in the prosperity as well as to the success of or downfall of the performance management.
An employee in a particular business organization will significantly deliver and be productive with the application of performance management. This may be an important outcome if there is a proper application of the integrated software contrary to the outcome that could be evident when the performance management uses a spreadsheet for a system of recording. The return on investment can be realized via a range of indirect as well as direct benefits of sales, benefits of operational efficiency and through making open of the latent capacity of every worker work day.
This implies the time spent by the employees not doing the jobs they are required to perform. Learning and management strategies are therefore crucial in performance management strategies since they encourage performance delivery as well as productivity of the business organization. As such, there would growth in sales, reduction of costs, decrease time as well as align the organization, motivation of the employees as well as improve the management control (De, 2013).
My Company and Employees
My company is king’s General Motors. The company deals with the automobiles, ranging from the motorcycles to huge tracks and buses. I have three hundred workers who very hardworking and competent in the jobs. My employees are engaged in the jobs such as management, the general assembly of the vehicles as well as sales and marketing of the company products.
Each and every department of the organization does a tremendous job in ensuring that the business succeeds in its endeavors. Such hard work performed by these departments has enabled the company to overcome the various challenges witnessed in the automobile industry all, over the globe.
Assessment of the Employees
To enhance the performance of each and every employee of the organization, I appoint a management team from each and every department of the organization to conduct the assessment of the employees in their departments. Various departments in the King’s General Motors employ different methods in assessing the workforce of the company.
In the department that deals with an assembly of the vehicles, applies the ranking system to enable it to gauge how much its employees perform in their respective fields of specialization. However, the remaining departments use appraisals to do the workers’’ assessment. The appraisals in the departments ensure that the workers are able to perform efficiently, competently and within the time stipulated by the departments to ensure quality work.
How I Provide Feedback
The assessment of my employees is usually conducted within a span of three months after each and every financial year. This serves the assessment right especially after the financial year when the company is able to ascertain its profits for a particular year. After the assessment, I usually provide the feedback for the same in an annual general meeting that is usually held at the company hall.
During the meeting the success and failures of the company are analyzed and criticized where need be, just to ensure that it is in, the right train as far as the progress of the company is concerned. The type of feedback provided is usually summative and is based on productivity that is related to what a particular worker or groups of workers do.
How I will Reward the Top Workers and the Low Performers
After the assessment of the performances of the employees, very many ways are used to reward workers who perform well as well as those who never do well in their duties. For the top workers, I usually reward them by promotion, increased remuneration as well as through recognition as either the worker of the year or the most proficient worker of the decade.
There is also Various presents and gifts given to such workers. My company is also concerned with the employees who are not doing well as far as their performances are concerned. Such workers are encouraged not to give up, but work harder. After this, the low performing workers are taken for in-services to enhance their performance.
Müller, F., & Friedli, T. (2015). Integration of a Strategic Performance Measurement and Management Process into the Management Landscape of a Manufacturing Network.
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Reforming India’s Higher Education to Make India Globally Competitive
Abstract
Higher education contributes to the development of every country. Education is a vital part of human resource development and empowerment in a country. In all education system, the higher education plays a critical role in equipping people with knowledge, skills, and values that in return enhance the growth and productivity of a country. Therefore, investments in education contribute the economic prosperity of a country. Since independence Indian Governments has addressed key challenges facing the education system.
The successive governments have improved access to education, expanded education infrastructure, and increased education funding. The government efforts have all contribute to a rise in literacy rates in India. The Indian education system has made progress in the last few decades. However, the system still faces significant challenges. There is a high student-teacher ratio that lowers the quality of education. There is a wide skill gap between industries and fresh graduates forcing companies to incur high cost in training and development of employees.
Additionally, there are high levels of inequality with students from poor background facing difficulties in accessing high education. The importance of the high education system in the nation cannot be ignored. Previous studies have focused on determining how government funding impacts on higher education. This study will shift focus to improving the quality of education to enhance the global position of India.
To compete globally, India must have an effective high education system. The study examines the current state of higher education in India. It highlights the challenges that the system is facing. The main aim of the study is to come up with comprehensive recommendations to deal improve higher learning in India.
Key Words
Globally competitive
Higher learning
Inequality
Skills
Introduction
In the last decades, India has made significant progress in improving the education system, but dropout rates and low levels of learning continue to challenge the country. The India Education system has become a major concern to the leaders of the country. In 2016, Indian Parliament tabled a report that looked at the various challenges that the education system is facing. India education is facing significant challenges that are impacting on the quality of education. There is a high shortage of teachers and a rise in demand for education.
The report indicated that one teacher can handle a class of over 1000 students (Klemencic & Fried, 2015). India is a young nation, and according to the census, 600 million Indians are under 25 years (Klemencic & Fried, 2015). With the current status of the education system, these young people may not access quality education. The dropout levels are relatively high in India. Lack of infrastructure and inadequate higher education facilities causes some of the students to drop out. Additionally, there is a significant gap between education and skills.
The education system has failed to equip students with the right skills to use in the job market. According to Kaur (2015), only one out of every four graduates is employable. The vision of the higher education system in India is to realize India’s human resource potential to its fullest, but if the education system fails to equip students with the right skills, then this aim is not being achieved. The government is supposed to provide citizens with the quality education. The study will assess the challenges that higher education system is facing in India and identify the measures that the government should put in place to provide all citizens with the quality education.
Research Questions
What is the current status of higher education in India?
What challenges is higher education facing in India?
How is higher education lowering India economic prosperity and increasing inequality rates?
How can higher education be improved to make India globally competitive?
Literature Review
Higher education is an important part of developing nations. Higher education is supposed to increase human development and provide the country with skilled and innovative graduates (Coleman, 2015). Since Independence, the higher education in India has shown tremendous progress. India higher education has so far produced doctors, engineers, managers and teachers who not only in demand in India but across the world. However, the higher education system is facing certain challenges that are limiting the ability to deliver its main objective of providing India with employable graduates.
The Indian Education System
The education system is under the Human Resource Development which consists of two departments the Department of School Education and Literacy and the Department of Higher Education (Kaur, 2015). The Department of Higher Education is responsible for higher education, technical education, and minority education. India Was colonized hence most of the education activities are in line with British education system.
The India education system previously followed the British model, but it has been improved over the years. The Indians use the 10 +2+3 system. Students spend 10 years in basic education, 2 years in senior general secondary education and 3 years in higher education (Mehrotra, 2014). For children between the age of 6 to 14 school attendance is compulsory. Adult education focuses on increasing literacy. Higher education is provided by the public and private sector (Kaur, 2015). The private sector falls under the jurisdiction of the government and rules that apply to government schools concerning curriculum also apply private education.
English is the language of instruction in India’s higher education system. The challenge is that at lower levels the language of instruction is the language of the region and it includes the following common languages Hindi, Punjabi, Tamil, Gujarati, and Bengali. English is introduced as a second language in Standard VI and in the last classes Standard XI and Standard XII the language of instruction is both English and Hindu (Pilkington, 2014). In higher learning, English is the main language of instructions, and some of the students who fail to acquire the right English skills have difficulties in higher education (Bhalla, 2015).
India has one of the largest education systems in the world. India has expanded infrastructure over the last few decades. Currently, the country has 35,000 colleges and 600 universities. Higher learning education in India is composed of Universities which offer Bachelors, Masters and Doctor’s Degree. Polytechnics and colleges provide certificate and diploma education (Kapur & Perry, 2015).
Universities in India are divided into two main categories the affiliating and unitary universities. The affiliating universities bring small colleges and institutions together. India has around 15,000 affiliating universities, and most of these affiliating institutions are private (Kapur & Perry, 2015). The unitary universities have no affiliated institutions, and they provide undergraduate and graduate education.
There are deemed universities in India. Deemed universities are considered to be of national importance. Some of the deemed universities were private institutions specializing in specific areas such as technology. Deemed universities specialize in a limited number of fields, but they have the same rights and rules as the ordinary universities.
India has 13 deemed universities mainly specializing in the field of technology and medicine. India has developed open universities. The first Open University was established in 1985 in Hyderabad. Other states such as Rajasthan, Maharashtra, Bihar, Karnataka and Gujarat have also established open universities (Kaur, 2015).
Challenges Facing Higher Education
The Teacher-Student Ratio
A study compared India Education system to other developed nations indicated that the student ratio is relatively high in India. The study concluded that in developed countries the average student-teacher ratio is 11.4 (Kapur & Perry, 2015). India student teacher ratio is double, and it currently stands at 22.0 (Klemencic & Fried, 2015). Research on Asian education system indicated that China stands ahead in the education system in Asia.
India and China have a large education system, but China has managed to improve the quality of education (Kapur & Perry, 2015). India education system was placed ahead of countries like Bangladesh. However, the study indicated that India is facing an acute shortage of teachers. Though India education system comes ahead of some of the underdeveloped countries, the teacher-student ratio was a major issue in India as opposed to other countries in Asia. In Western Asia,
For instance, the student teacher ratio was 15.3, and this is still better that India’s high student-teacher ratio (Rizvi & Gorur, 2014). The high student-teacher is causing serious impacts on education quality. The teachers have to handle many students, and this is increasing demotivation levels among teachers due to overworking.
Quality of Education
A survey conducted on engineering students indicated that only 25% of engineering graduates are employable (Mehrotra, 2014). Out five engineer graduates only 2 are qualified for jobs in the Indian market. This survey indicates the seriousness in the quality of education offered in higher learning. The main objective if higher learning in India is yet to be achieved.
The quality of education delivered in most higher learning institutions is poor. The students produced by the education system do not have the right skills at the job market. Industries face a problem of finding suitable employees, and they have to incur high costs in training and development of employees.
Poor education quality is the lack of teachers is contributing to poor education quality. Teaching is not an attractive course in India. In India, attractive courses are engineering and medicine. Families are putting a lot of pressure on children to become doctors and engineers.
Those who decide to take courses such as teaching are not held in high regard in the families making it a less attractive course. Teaching has been identified as the last choice of career. The number of teachers produced is low (Tomar, 2014). In higher learning institutions, the number of Ph.Ds that are required is very low. Some institutions are being forced to hire fresh graduates to teach in universities leading to poor quality of classroom instructions.
Inequality
The Indian government is facing a major challenge of providing access to quality education to students from poor families. Students from poor backgrounds are disadvantaged in India. India education system has been politicized (Coleman, 2015). Some of the private institutions are owned by politicians and use government influence to forward person interest. The Indian education is expensive, and some of the students from a poor background cannot afford higher learning education (Tomar, 2014). Additionally, students are further disadvantaged since they are not academically prepared to sit for a competitive entrance examination. The urban elite and rich students are prepared for exams since they can access private tuition and coaching.
Reforming Higher Education
India has a young population unlike some developed countries such as China, Japan, and the USA are dealing with challenges of an aging population. India must take advantage of young population to improve the economic prosperity of India and global position. India can draw various lessons from China in reforming the education system.
China faced a shortage of higher learning institutions, and the government established a massive support for Chinese Nations in oversee schools (Kapur & Perry, 2015). The benefit of using this strategy is Indian Nationals will get education India hence they are more likely to bring new ideas. Educating students abroad will enhance the position of India globally because it will prepare students for the global market.
Elearning has been used in developed countries such as USA, France, Australia, and the UK (Pilkington, 2014). Elearning will enhance access to education and reduce the congestion of existing facilities.
Aims and Objectives
The study seeks to establish the current scenario in higher learning education in India. It is important to understand the current status of the higher learning education before coming up with strategies to deal with the issues that higher learning is facing. The Indian education system has faced various challenges in the past, and every government has come up with various strategies to deal with challenges. The efforts of the government have contributed to the improvements of the current education system.
For instance, in 1995, India only had 25 higher learning institutions, but today it has over 600 higher learning institutions (Jain, Kadri, Ramanathan, & Ahmed, 2015). India has improved education infrastructure to become one of the largest education systems in the world. Statistics indicate that India is the third largest higher education system and comes behind the China and the United States (Jain, Kadri, Ramanathan, & Ahmed, 2015). Understanding the current status of the education system will be useful in identifying various areas in the education system that is yet to be developed.
Going through past studies in India education system indicates that there is a gap between skills developed in higher learning education and those required in the marketplace. This form a good basis to evaluate the quality of high learning education and assessing certain factors that contribute to poor quality education. Additionally, understating the current status will create a good foundation to come up with suitable recommendations to improve the quality of higher learning education.
The second objective is to examine the challenges and opportunities faced by Indian Higher Learning Education. Higher learning institutions are facing diverse challenges impacting on the quality of education. Inequality has been cited as a major challenge in higher learning. States that are relatively rich have higher learning institutions as opposed to states that are relatively poor.
Additionally, the student-teacher ratio has become a major concern. The shortage in teachers is a nationwide problem that is not affecting higher learning but other levels of education. Examining the challenges that higher learning is an important objective of the research as it will show the need to improve the higher learning institutions. Most studies in India focus on government spending and infrastructure as the main challenge it is important to give other challenges additional attention in order to come up with comprehensive suggestions to transform education sector in India.
The third objective is to find out the role of higher learning education in making India globally competitive. Higher learning education is an important factor in every country. Every country is investing in higher learning education to improve the global competitiveness of the country.in the global market knowledge determines the level of empowerment.
Research conducted by the University Grants Commission indicated that the India must increase universities by 1500 to compete in the globally (Pilkington, 2014). India is missing out on the opportunities offered by the global market. The gross enrolment of India in higher learning education is 11% which is small compared to China 20%, South Korea 91% and USA 83% (Coleman, 2015). Previous studies have focused on showing the impact of low enrolment levels in higher education on the economic performance of the country.
This study will look at impact at the global level and show how countries that have invested in higher learning are ahead of India in the global market. This study can draw ideas from past studies in countries such as China, and South Korea which is in Asia but they have managed to improve the higher learning education. The ideas will be used to identify various measures of transforming higher learning education in India to make India globally competitive.
The fourth objective is to come up with suggestions to improve higher learning education in India. By assessing the current status of Indian education system, it is possible to come up with various strategies improve the quality of higher learning education, and lower inequality (Pilkington, 2014). The study will draw suggestion from developed nations that can be implemented in India.
One of the suggestions is establishing e-learning in India higher learning education to increase accessibility. India can also establish massive programs to fund oversee education for Indians to provide people from the disadvantaged background with an opportunity to study abroad. The study will recommend an increase in government funding in higher learning education. Government funding will be used to reduce inequality and increase research and development in higher learning institutions.
Methodology
Research methodology describes the methods and procedures used to conduct a study. The effectiveness of a study is determined by choice of methodology for both collection and evaluation of data. The research methodology will develop the research design, procedures, and data collection analysis method that will be useful in understanding the higher education in India.
Type of Research
The topic of the research is to study the higher learning education system in India. The study is focused on understanding the current status of India education, highlighting challenges and opportunities, evaluating the role of higher learning education in global competition and coming with suggestions to improve higher learning education (Altbach, 2015). The type of research that that is suitable for the study is descriptive research. Data will be collected from the higher learning institutions to assess the current performance and come up with strategies hence the descriptive research will be suitable for this study.
Research Design
The research will mainly make use of secondary data and primary data. Secondary data will be the main source of data for the study secondary data will be easier to access, and it will save on time and money to conduct the research.
Secondary Sources
Secondary data involves data collected from another source. There are wide sources of secondary data for this study. The main secondary sources of data that will be used include annual reports of UGC, and Education Department, Economic Surveys, journals, websites, books, and Planning Commissions publications (Mehrotra, 2014). This study will make use of government publication on higher learning institutions.
Government publications will be useful in identifying government funding in higher learning institutions. Additionally, it will be used to determine the measure that government has already put in place to improve higher learning education. The Ministry of Human development in India will be a good source of information to be used in this study.
The ministry publication and website will be used to provide information on the scenario of high learning education. From this ministry, it is possible to understand the Indian Education system and infrastructure levels. Statistics collected by the Higher Learning Department will be incorporated in this study to assess the enrollment levels, dropout rates and a number of graduates.
Industry data will further be used to assess the quality of higher learning education. The study will focus on engineering industry in India and determine if the graduates that are produced by higher learning institutions are ready to work in engineering industry (Rizvi & Gorur, 2014). Industry data will be used to determine the amount of money that is spent on training and development of employees due to the skills gap in the marketplace and higher learning institutions.
It is important to examine the inequality levels in higher learning. To assess the inequality levels, the study will focus on two states, a rich and poor state. The rich state that will be used is Delhi, and poor state is Manipur. The two states were chosen on the basis that Delhi has a low poverty rate of 9.91 whereas Manipur has a high poverty rate of 36.89.
Secondary data sources will be used to determine the number of students who access quality high education in the state of Delhi compared to the state of Manipur. The comparison will also be made in terms of the number of higher learning institutions in Delhi and Manipur.
To ensure that credibility of the study is not compromised, only reliable sources will be used. The study will make use peer-reviewed journals, government websites, and higher learning institutions publications and websites. Only credible journals, books, and newspapers will be used to collect secondary data.
Primary Sources
Given that respondents are located at a long distance, the only primary data collection method is mail questionnaire. The study will make use of mail questionnaire to collect primary data. The research will focus on getting mail contact address and request individuals to respond to questionnaires. The mailed questionnaire will cover certain aspects which include general information on India education system, infrastructure, and facilities in higher learning institutions, student teacher ratio, and accessibility of high learning institutions.
The mailed questionnaire will target 100 students in the University of Delhi. The study will be focusing on a large number because the rate response in mail questionnaire is relatively low. By sending many mailed questionnaires, the study is likely to get more responses.
Data Analysis
Data analysis will make use of various statically methods to evaluate the data. Collected data from secondary sources and primary sources will be used to test various hypotheses that the study focuses on. The government collected from the government, department of higher learning and higher learning institutions will be used to develop tables to indicate the growth in higher learning enrolment.
Tables on the expenditure of government on higher learning will be developed. To further enhance the analysis, the researcher can develop tables that compare the % of government funding in higher learning between India, and other countries. Graphs can also be developed to show how education facilities are distributed in the states of India. Based on data collected, past data will be used to determine the future needs of higher learning and show that the student-teacher ratio will continue to persist if it is not addressed today.
Limitations of Study
Relying on secondary sources will have various limitations on the study. There will be sampling issues since sample used in the previous studies may not adequately represent the whole population. Accessing certain secondary data will be difficult such as getting accurate data on the student-teacher ratio in certain universities.
Use of mail questionnaire causes certain limitations. Respondents can fill the questionnaire at own convenience hence may fail to provide the right information. The response rate is relatively low.
It is important to overcome the limitations and maintain the effectiveness of research. The study will minimize the limitations by using credible and reliable secondary sources. The study will send many mail questionnaire to ensure that they get a large number of respondents.
Conclusion
Higher learning is instrumental to the development of a country. It provides the country with the right people to drive innovation and improve the economic status of a country. India high learning education is facing various challenges that are reducing ability to achieve its vision and objectives. There is a high student-teacher ratio. As a result, teachers are handling many students lowering the quality of education.
Inequality levels are relatively high in higher learning. The poor students are disadvantaged when it comes to handling exams and accessing higher learning institutions. The high cost of high learning institutions is causing a high rate of drop-out among the poor students. The current status of India education indicates the need to transform high learning education. The study aims at finding effective measures that India can take to deal with higher learning education.
The study will recommend the use of e-learning to increase access. The government will have to increase expenditure on higher learning to upgrade higher education in India and move towards e-learning. The government can also establish massive abroad programs for Indian nationals. It can provide students from poor backgrounds to study abroad to lower the congestion at the existing universities. There is a need to establish industry and academia connection to ensure that students acquire skills required for the marketplace.
Bhalla, V. (2015). International students at Indian universities. International higher education, 1-5.
Coleman, J. (2015). Education and Political Development.(SPD-4) (Vol. 4). Princeton University Press.
Jain, S., Kadri, V., Ramanathan, K., & Ahmed, M. (2015). A Statistical Approach to Modernize the Indian Higher Education System for Rural and Vernacular Students.
Kapur, D., & Perry, E. (2015). Higher Education reform in China and India: the role of the State. Journal of Havard, 1.
Kaur, H. (2015). Raising the quality standards in Indian higher education system. An International Multidisciplinary Research Journal, 5(3), 251-259.
Klemencic, M., & Fried, J. (2015). Demographic challenges and future of the higher education. International Higher Education, (47).
Mehrotra, S. (2014). India’s Skills Challenge: Reforming Vocational Education and Training to Harness the Demographic Dividend. New York: Oxford University Press.
Pilkington, M. (2014). Converging higher education systems in a global setting: The example of France and India. European Journal of Education, 49(1), 113-126.
Rizvi, F., & Gorur, R. (2014). Harnessing Global Resources for Reforming India Higher Education.
Tomar, D. (2014). A comparative study of service quality perception between public and the private sector in the Indian Higher Education System. International Journal of Applied Services Marketing Perspectives, 3(4), 1304.
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The class is made up of young adults ranging from 20-26 years. Some of the listeners are people with the condition but have not publicly spoken about it, or have close relatives or friends with the condition. Others might have the condition but do not know their status since they have not and cannot go for examination. This is a group that wants to learn about the various types of diabetes to adopt appropriate ways of living their lives better.
For those with the condition already, they want to understand the right course of action to take and for those without; they want to learn about how they can modify their lifestyles and prevent themselves from engaging in the way of life that can result in them acquiring the condition. Also, the fact that they are relatively young, most in their 20s, they are energetic and keen about life. For some too, this is the age to enjoy life without limits.
They lust for knowledge but must be handled with care so as not to antagonize them. Their opinions, whether well informed or not, must be listened to and accorded the respect. Thus, the best way to progress with the class is through discussion. It should be highly interactive to give room for them to air their opinions confidently.
Educational Setting
The setting of the class is a college. The staff working here are mostly degree and diploma holders depending in their area of specialization and the department they work. All the academic staff is made up of degree holders as a requirement by the government. The support staff, on the other hand, is mostly people with diplomas. However, we must face the fact that the students mostly meet with the teachers and interact more with them.
It is thus safe to conclude that they interact with well-educated and informed people in the school whether the academic or support staff. Another fact that cannot go unmentioned is that most of the staff is made up of young adults ranging from 30-45 years. It shows the institution’s aim of trying to integrate the student body and the staff better. Several in-service training for the staff exists to continuously equip the staff with necessary skills in dealing with the students.
Being college students, they are knowledgeable about diabetes. They are aware of the causes, and the fact that it has no cure is universal knowledge among all the students. However, most of them have never dealt or cared for a diabetic patient. They only feel it is beyond their league. They believe it is a specialty for the medical personnel. And others too feel it is an exaggerated illness. They believe diabetes is not a top killer as they consider cancer and HIV being the worse illnesses.
The learners come from diversified family backgrounds. It is quite hard to put them into categories regarding their education. Some parents are semi-educated while others are well educated. But one fact is, all the parents are socially educated. They know what is right and what is wrong with their children. However, most of these parents believe in some myths surrounding the diabetes calamity. The good thing is that they agree about the causes of the disease.
Learner Assessments
The class is made up of college students. At the end of their course, they will be qualified diploma holders. This is a relatively educated group, which can grasp the fairly complex material and do what is expected of them. If well taught about a certain subject, they will understand the concepts and how to implement the ideas.
Also, at this age, they are eager to conquer the world. They understand the importance of education and thus are eager to learn more. They want to show the world that they are knowledgeable and that keeps their academic thirst going. The reason for choosing this seemingly normal disease is that it resonates well with the class. The class is made up young people who are mostly dating. To most of them, it is a thrill being in a relationship, which is cool by itself. However, the peak of these relationships is engaging in harmful lifestyles about their diets and lack of exercises.
This is despite the fact that most cases of diabetes are caused by lack of proper exercise and the consumption of sugary food. The lesson is to question why this continually happens with parents and teachers guiding these young people. Can the prevalence be blamed on the teachers, parents or the students themselves? To fill this gap, the lesson is very vital since the answer lies in the minds of these students.
Topic Selection Rationale
The main teaching philosophy is through discussion. The discussion is the best method of delivery due to the nature of this sensitive subject. Despite the fact that the young people know the dangers of not exercising proper diet, it is still an increasing trend. Moreover, most people hate being guided in such intimate matters. They feel like the others are intruding into their private life.
They want to be left alone and do what they want with their lives. In any case, they say they are adults albeit naïve ones. The discussion thus becomes handy in such a situation. This becomes easier with college students since they are educated, eager to explore and ever ready to be heard. The discussion should start with a simple introduction. A brief introduction to the topic, reasons for the topic and specifically why the class is chosen.
It is to remove further any imaginary boundaries between the educator and the students that may exist in the minds of the students. The discussion should focus on a patient suffering from the disease. It should be a right scenario where the focus rotates on how the patient acquired such a disease. Also, on how he behaved upon learning of his condition and how he lives with the condition.
The discussion will be around a man living with diabetes known as Peter. He is 28 years of age, which is a small deviation from the age of some students. The only minor difference is that he was diagnosed with the disease while still in the university some five years ago. The description of his college social life leaves nothing to be desired though it clearly resonates with the young students.
He was a person that did not like practicing and used to consume a lot of sugary food. He slept with almost all of them who were too eager to be linked with the campus celebrity. Besides the lazy behavior, Peter was an alcoholic and would regularly be found in the clubs if he was not in his room sleeping. This behavior made him have a very poor hygiene with no regular exercises and the use various sugary foodstuffs besides the alcohol that had turned to be his best friend.
After some time, Peter developed some complications that were associated with often urination, regular feelings of thirst, blurry vision, extreme fatigue, loss of weight and numbness in the hands and feet (Herr, et al. 2013). This led to him being examined by the doctor for the symptoms of diabetes. After the examination, received the shock of his life when the results returned positive of diabetes mellitus.
He felt as if his celebrated life was over. It took some time and the efforts of his parents to make him accept the situation. He followed the doctors’ advice, and he coped well. His winning attitude helped a lot too. And now, he has four years to his name living with diabetes. His simple advice to young people is; avoid inappropriate diet and alcohol and also practice regularly through running or other field events.
Conclusion
The students discussed all aspects of this case above from the causes to the final stage of accepting one’s status. They found out that speaking out also helps a great deal. The discussion is fruitful if the class participates well. The interactions amongst themselves and also between them and the educator equip them with knowledge on diabetes. The discussion is the best mode of teaching a young class which is expected to impart this knowledge to others further. It gives them the freedom to think on any angle and widen their knowledge gap due to the peer discussion.
This campaign focuses on elderly falls. World Health Organization (WHO) defines fall as “an event that results in a person coming to rest inadvertently on the ground, floor or lower level” (2013). Many older adults fall, making them succumbs to severe injuries, many of which make them lose the ability to be self-independent and cause financial strains. On an annual basis, approximately 30-40% of the people aged over sixty-five years experience a fall at least once a year (Nicklett & Taylor, 2014).
Similarly, about 50% of those in nursing homes have experienced a decline in the within the last one year. Falls are recognized as the leading cause of accidental deaths in this age group, and in the UK, it is the 7th principal death cause. Studies indicate that 75% of the deaths among the elderly are associated with unintentional falls (Robertson & Gillespie, 2013).
Moreover, about 258,000 of the old people are admitted to hospitals annually as a result of hip fractures that result from falls (Rau et al., 2014). This hinders a high quality of life and causes immense medical costs. In 2013, direct medical expenses incurred from falls were as high as thirty billion (Robertson & Gillespie, 2013).
There is a projection that by 2020, over forty-four billion dollars will be dedicated towards these injuries (Robertson & Gillespie, 2013). These statistics make it apparent that falls among the elderly are a topic that needs to be campaigned on so that communities can take preventive measures. This would contribute to the lesser prevalence of the challenge.
Theories
Social learning theory
Social learning theory was developed by Albert Bandura (1977). Bandura explains that people learn in social environments by observing others and then imitates the behavior of others. In essence, this theory indicates that learning process is not just through reinforcement but also through influence from others (Cubas et al., 2015). There are four principles of social learning theory that have been developed namely attention, retention, reproduction and motivation. Inattention principle, learning will not occur if people are not focused.
Therefore, to obtain attention, it is important to design the training materials for patient fall prevention intervention differently so as to reinforce targeted group perceptions (Aliakbari, Parvin, Heidari, & Haghani, 2015). The targeted group includes nurses, elderly people representatives, unit nurse manager, registered nurses, nurse educators, orthopedic, physicians and community leaders.
The second principle is retention which states that people learn by internalizing the information stored in their memories. In this context, the training information will be designed in a manner that one can recall and respond appropriately (as taught). The third principle is reproduction which states that people actions are based on the information (behavior, knowledge or skills) previously learned (Aliakbari, Parvin, Heidari, & Haghani, 2015).
The training will be done in a way that it improves mental and physical rehearsal to ensure that the targeted populations reproduce the actions learned. Motivation is the last principle of this theory which states that most people’s actions are motivated, especially when they observe other people getting rewarded after for their actions. This motivation will help the people to do the same act (Cubas et al., 2015).
This theory works as a bridge between cognitive and behaviorist learning theories as it entails of motivation, memory, and attention. Therefore, when developing the campaign tool, one will focus on the novel as well as unique contexts that capture the targeted population attention in a manner that it stands out in their memory (Cubas et al., 2015).
The designing of the campaign tool will be done in a way that helps the targeted population to develop this self- efficacy individually through constructive feedback and confidence building. This concept in social learning theory is referred to as social modeling, and has been shown to be an effective method of education (which is the campaigns tool focus) (Aliakbari, Parvin, Heidari, & Haghani, 2015).
Stages of change model
The stages of change model also known as Transtheoretical Model was developed by James Prochaska and Carlo Diclemente in the early 1980s (Prochaska, 2013). According to this model, one should not assume that every person is ready for change because each individual has differing readiness to change. Therefore, when designing the campaigning tool, it is important to identify the target group position in the change process to match intervention to the people’s readiness to change. It is a bio psychosocial, integrative model for conceptualizing the intentional behavior change’s process (Lee, Park, & Min, 2015).
The stages of changes identified by this model included a) pre-contemplation, b) contemplation, c) preparation, d) action and e) maintenance. During the pre-contemplation, the target group is likely to be ignorant because they are not ready to adopt interventions foreseeable in the future (Prochaska, 2013). In this context, the campaigning tool is designed in a way that it encourages a re-evaluation of the existing behavior, explains, and supports self- exploration.
The contemplation stage is where the person is totally not ready for the change. The second stage is the consideration stage where people start becoming ambivalent to change. Therefore, the campaign tool is designed to ensure that it promotes the adoption of the suggested interventions (Lee, Park, & Min, 2015).
The third stage is the preparation stage which a stage where people are ready to change. In the action stage, people make specific overt modifications in their lifestyles (Prochaska, 2013). The campaigning tool is designed to enhance self-efficacy especially when dealing with obstacles and to help guard the frustrations. The last stage of this model is the maintenance stage which mainly focuses on the ongoing changes. In this case, maintenance will be reinforced through follow-up support (Lee, Park, & Min, 2015).
The rationale of the health promotion campaign based on stages of change model
This theory emphasizes on the role of other people during decision-making processes. The stages of change model apply in the elderly fall’s campaign. The first step was the presentation of negative impacts associated with old peoples’ falls. This is aimed at convincing the stakeholders about the urgency and need for change. Secondly, the theory helped one to expand people’s understanding of the social processes that influence the success of an implementation process (Prochaska, 2013).
Based on this model, some resistance is expected because most of the stakeholders already had a particular lifestyle and therefore making the changes needed to prevent falls would be met with some reluctance. The target group would move through the various stages as they try to weigh whether to change or not (Karlsson et al., 2013). The value of this approach is that it lays emphasis on professional communication where the caregiver’s providers can support one another. As such, offering them accurate information would be essential in promoting the change (Prochaska, 2013).
Effectiveness of the approved health promotion activity
The health promotion activity was sufficient because it explored the facilitators and barriers of elderly falls to develop strategic, evidence-based support aids in the reduction of the old falls (Prochaska, 2013). The training campaign on elderly falls preventive measure was useful because it was cost friendly (that is no huge costs are required to implement them) easy implementation process and it reached a large number of people at the same time (Balzer et al., 2012).
Own participation in the approved health promotion activity
The own primary involvement was through advocacy and mobilizing of the campaign to the stakeholders. The campaign took place at a community center hall for two days from 10.00Am to 3.00Pm. The participation involved creating rapport with the interested parties involved (nurses, elderly people representatives, unit nurse manager, registered nurses, nurse educators, orthopedic, physicians and community leaders).
This was critical in ensuring that they were open and at ease to discuss the factors that were contributing to elderly falls. This was vital as it made the target group and other involved stakeholders understand the importance of addressing the unique demands of older patients, which require patience as some of the seniors may have the hearing, language, and cognition problems. I also offered education on the strategic preventive measures against falls.
Whether the campaign was successful and had value and impact
The whole campaign was successful as detailed planning was done at every stage. The older adults and caregivers understood the reasons as to why falls had to be prevented. The campaign’s value and the impact were evident from the reduced prevalence of falls among the elderly, lesser hospitalizations, smaller costs dedicated towards falls, and an improved general wellbeing and health of the target group.
Strengths and weaknesses
The community members were able to learn a lot of insights about falls. The uptake of training on effective fall prevention measures was quite active; which increased awareness to the population that the aspect of fall is a healthcare concern (Gillespie et al., 2012). S
ome caregivers who previously did not have a caring attitude towards the elderly changed their attitudes and behavior after training, and most of the organizations were keen to implement some of the suggested change initiatives. However, a lot of time and resources had to be taken during the planning and implementation stages. This was quite strenuous. At the same time, reaching the seniors was a challenge due to their limited mobility.
Barriers and three recommendations on improving the campaign
The main obstacles were a lack of knowledge and motivation of healthcare providers, lack of change champions among the healthcare staff, language barriers, and lack of adequate resources. In future, the language barrier issues can be addressed by having a translator during any interaction with English non-speaking group. More efforts will be made so as to mobilize adequate resourced from stakeholders (Karlsson et al., 2013). This includes applying for funding from the government.
Lastly, leadership is an important aspect in implementing change in all organizations. The healthcare staff will be encouraged to attend leadership and management training so that they can understand better about their leadership roles and to offer a strong support and direction to the team members when implementing change. This will help the healthcare professionals to embrace their role as champions and facilitator in promoting and implementing change in their respective workstation (Karlsson et al., 2013).
Involvement in the campaign
The stakeholders involved in this campaign included; nurses, elderly people representatives, unit nurse manager, registered nurses, nurse educators, orthopedic, physicians and community leaders. Involving all the relevant stakeholders is very pivotal in promoting success. This is because they shape the direction of change in the early stages (Prochaska, 2013).
Involving the stakeholders will also ensure that all the project’s resources are available and provide insight about the probable reaction to project’s outcome or the necessary adjustments that must be made so as to win the community’s support. The benefits of all inclusive stakeholders involvement in this campaign is that it reduced distrust of the campaign’s outcome, increased commitment to the campaign processes and objectives and heightened the credibility of this campaign (Robertson &Gillespie, 2013).
Reflection
Collectively, this theory was useful in developing the multifaceted interventions that targeted change, promoted caregivers behavior, and ultimately improved the outcome of the campaign. An evaluation would be made after some duration after the changes have been embraced as a way of ensuring that the right things are being done appropriately (Balzer et al., 2012). Also, there are several elements identified after listening to other group’s presentation that we can adopt in the future. For instance, the use of pamphlets would have been effective as it would ensure that the information is widespread. Some groups used T-shirts to brand their campaign and to increase their coverage.
Conclusion
The campaign went well as the change model and theoretical frameworks used were correct for the topic. There are few aspects that many need to be refined according to our reviewer’s constructive criticism. However, participating in this activity was a good learning experience.
References
Aliakbari, F., Parvin, N., Heidari, M., & Haghani, F. (2015). Learning theories application in nursing education. Journal of Education and Health Promotion, 4, 2. http://doi.org/10.4103/2277-9531.151867
Balzer, K., Bremer, M., Schramm, S., Lühmann, D., &Raspe, H. (2012).Falls prevention for the elderly.GMS Health Technol Assess 8: Doc01.
Cubas, M. R., Costa, E. C. R. D., Malucelli, A., Nichiata, L. Y. I., & Enembreck, F. S. (2015). Components of social learning theory in a tool for teaching Nursing. Revista Brasileira de Enfermagem, 68(5), 906-912.
Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., et al. (2012).Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev.
Karlsson, M. K., Vonschewelov, T., Karlsson, C., Cöster, M., &Rosengen, B. E. (2013). Prevention of falls in the elderly: a review. Scand J Public Health 41: 442-454.
Lee, J. Y., Park, H. A., & Min, Y. H. (2015). Transtheoretical Model-based nursing intervention on lifestyle change: A review focused on intervention delivery methods. Asian nursing research, 9(2), 158-167.
Michael, Y. L., Lin, J. S., Whitlock, E. P., Gold, R., Fu, R. et al. (2010).Interventions to Prevent Falls in Older Adults: An Updated Systematic Review. Rockville (MD): Agency for Healthcare Research and Quality (US).
Robertson, M. C., &Gillespie, L. D. (2013). Fall prevention in community-dwelling older adults. JAMA 309: 1406-1407
Nicklett, E. J., & Taylor, R. J. (2014). Racial/ethnic predictors of falls among older adults: The Health and Retirement Study. Journal of Aging and Health, 26(6), 1060–1075. http://doi.org/10.1177/0898264314541698.
Rau, C.-S., Lin, T.-S., Wu, S.-C., Yang, J. C.-S., Hsu, S.-Y., Cho, T.-Y., & Hsieh, C.-H. (2014). Geriatric hospitalizations in fall-related injuries. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 22, 63. http://doi.org/10.1186/s13049-014-0063-1
Prochaska, J. O. (2013). Transtheoretical model of behavior change. In Encyclopedia of behavioral medicine (pp. 1997-2000). Springer New York.
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Part 1: Code Blue educational video from the Regina Qu’Appelle Health Region.
Time sequence
Issue noted
code
comments
0-22 seconds
Breach of Australian Resuscitation Council Guidelines:
BARCG- Guideline 2 priorities in an emergency
Finds Mr. Smith unresponsive. Fails to follow the Guide 2 BLS algorithm because she failed to assess danger, but she assessed the airway, as she is seen checking for the escape of air from the patients mouth or nose as recommended by guide 5. Implications: Delay in resuscitation processes increases the risk of reduced cardiac output to the brain due to poor compressions.
Time 3.26
Poor technical skills
PTS – BARCG Guide 6 & 8
Chest compressions inadequate as recommended by Guide 6. The recommended chest compressions are 30 chest compressions followed by two breaths. The chest compressions are slow than required by Guide 8. “A good CPR should deliver chest compressions over the lower half of the sternum at a depth of 5 cm” (ARC guide 8). Long pauses in CPR before shock delivery. Guide 6 discourages long pauses and distractions during a CPR Implications: Long pauses, distractions, slow and inadequate chest compressions lower the chance of patient’s survival
Poor Non-Technical skillsPNTS
Time 0.30
Situation awareness
PNTS- SA
The nurse did not press the emergency push button system to call for help immediately and instead used the overturn Implications: Delayed response by the code blue team
Time 0.30 secsTime 2.26 minutes
Decision making
PNTS- DM
Delay in full code response. The team arrived 2 minutes later after the call alert Implications: This led to delay important activities such as defibrillation. However, the rest of the decisions such as medication, hyperventilation and defibrillation activities went on well once the code blue captain arrived.
Time 3.36
Task management
PNTS-TM
Compressors for more than five cycles. One compressor was working for almost 5 minutes which is too long for a compressor. According to Guide 5, “the compressor roles approximately after 2 minutes or after five cycles of compressions and ventilations at a ratio of 30:2 so as to maintain the quality of compressions” (ARC guide 5). However, other task management processes such as airway positioning, nasopharyngeal airway placement, bag-valve mask ventilation were correctly performed.
Time 5.28Time 12.55
Communication
PNTS- comm
Occasionally fails to use the closed up communication which leads to miscommunications. For instance, at minute 12.55, the recorder had missed recording the endotracheal tube particulars due to poor communication strategy. The team used the SBAR technique to report the patient’s medical history to the code blue team leader. All the information was recorded including all the medication administered and other CPR outcomes such as cardiac rhythm before a shock was delivered. This is vital for future references.
Teamwork
PNTS-Team
No introduction was done by the team members, but they delegated the resuscitation duties appropriately. The team consisted of a coordinator, compressor nurse, airway manager, nurse in charge of defibrillator, captain/leader and crash cart manager.
Leadership
PNTS- Leadership
The leader failed to evaluate the BLS on arrival. However, Mr. Sellinger (the code captain) performed his tasks effectively including identification of cardiac rhythm, initiation of ACLS protocol, and evaluation of the protocol reviewed the code blue documentation form and signed the code blue form after completing the code blue.
PART 2: Analysis of the issues covered
Code blue should be contacted immediately for all unresponsive patients. Calling for help and initiation for help should be done simultaneously. One of the issues identified in this case study is delayed in the response of code blue code due to poor call out systems. The code team member should call out loudly for help through the facility-wide response system. In this technology, the nurse should have pressed the Blue code push button to ensure that the code blue team were notified accordingly (Bayramoglu et al., 2013).
As the nurse in charge waits for code blue team, he or she should initiate CPR (Clarke, Apesoa-Varano, & Barton, 2016). The code team are expected to introduce themselves as they arrive as well as and their roles statements such as “Am Mr. J. and will take document” or “I’ll take the airway” which helps in ensuring there is clear role differentiation. The service user physician should be contacted immediately.
According to Price, Applegarth & Price (2012), the healthcare provider should first assess the patient dangers and risks before they start the air management. This was not done in the case study and violated the ARC guide four which states that the patient’s mouth should be opened and head slightly turned downwards to remove the airways (Australian Resuscitation Council, 2008).
An ineffective cough indicates a severe obstruction. In this case, if the patient is responsive, the healthcare provider should give about five back blows, and if still, it is ineffective, they should give at least five chest thrusts (McInnes et al., 2012). This article states that for all unresponsive patients, the healthcare should send for help and start CPR immediately. Similarly, guideline 5 recommends that all patients who are breathing abnormally or are unresponsive require being resuscitated.
The first thing when assessing breathing, the rescuers should check for movement around the chest (lower part) and abdomen (upper part). They should check for the exhalation through the patient’s oral cavity or nose, and feel the movement of air in the patient’s mouth or nose. The guide recommends a ratio of compressions to rescue breaths as 30:2 (Australian Resuscitation Council, 2008).
According to this article, the first nurse to respond should start saving the patient’s life by performing chest compressions immediately (100 compressions per minute). Although important, the nurse should not wait for backboard , they should start chest compressions as it can be put in place later when the code team arrives. The switching the compressor roles in the case study is present but it took quite a long time than that recommended by ARC guide 6 which is approximately after 2 minutes.
To maintain the quality, the ventilations ratio should be maintained at 30:2 (Castelao et al., 2013). This is supported by Guide 6 which recommends that interruptions to chest compressions should be minimized. The best location to perform the compressions is the sternum- the lower half part of it. The healthcare provider’s heel is placed at the central part of the chest and put the other hand on top it. The recommended rates of compressions are 100 to 120 compressions per minute which are about two compressions per second.
The guide also outlines on the quality of compressions ( which is identified as poor in the case study) where it suggests that depth of compressions should be “at least 2 inches (5cm) with complete chest recoil after every compression” this helps the heart to re-fill completely by the next round of compressions. The number of interruptions should be minimized to ensure maintain the quantity and quality of compressions (Eroglu et al., 2014).
According to the article, the patient should be given 2 ventilations for every 30 seconds of oxygen-bag-mask device assisted ventilation. The oxygen level should be set to the flow meter 15 L/min, and where applicable, the reservoir should be fully open ensure that the patient gets 100% oxygen for each breath. One strength observed in the study is the fact that bag-mask device is best done by two blue code team members where one open the airway to fasten the mask on whereas the second one squeezes the oxygen bag.
Also, the article states that defibrillation is very critical and that the use of placement hands-free defibrillation pads is a safer option than hands held defibrillation paddles (Girotra et al., 2012; Prince et al., 2014). The article states that the deployment of automated external defibrillators (AED) should be used as soon as possible as it reduces mortality and morbidity associated with cardiac arrest caused by either ventricular fibrillation or ventricular tachycardia (Australian Resuscitation Council, 2008).
The compressions should resume immediately after delivering shock even with a normal heart rhythm as it will not provide enough cardiac output that will ensure adequate perfusion. It is recommended that 2 minutes the cardiac rhythm should be assessed after 5 cycles of a CPR (Merchant et al., 2014). The use of vasopressors in cardiac arrest is recommended only when there are no high-quality CPR. It is important to be extra cautious when administering a drug. This is because miscommunication is a common issue which often leads in the administration of incorrect drug doses or medications.
This can be prevented by using “closed loop” method of communication (Segon et al., 2014; William et al., 2016). For instance, when a nurse receives an order to inject some medicine, they should repeat the information of drug prescribed out loud, inject it and then announce it again after administration (Price et al., 2012). This method was used in some instances, but in the instance that it was absent, the recorder was prone to miss out some key aspects; for example, in this code blue simulation, the recorder had missed recording the endotracheal tube measurements.
The article suggests that an effective code blue team should have leader who controls the all the procedures and efforts of resuscitation. They communicate with the staff involved and evaluate the cardiac rhythm of a patient. Mr. Sellinger is the team captain of the case study and was standing in a position such that he could effectively see all of the resuscitation procedures and efforts. If the organization allows, the family member can be allowed into the room. It is also important to ensure that the information is well recorded.
In the case study, the recorder is shown documenting all the resuscitation process. However, it is important to understand that documentation process is done according the healthcare facility’s policy (McEvoy et al., 2014; Sahin et al., 2016). The recorder should remind the code team when time for a specific task has elapsed and must record all the activities taking place including the medicines prescribed. The article also suggests that all clinical areas should grant quick access to equipment such as blood glucose, blood pressure, and equipment of pulse oximetry and other equipment so as to effectively manage a deteriorating patient (Clarke, Carolina Apesoa-Varano, & Barton, 2016).
Through this case study, it is evident code training programs using simulation is beneficial and has been recommended by various healthcare institution organizations since 1999. This training will help the learners to improve cardiac resuscitation outcomes as it offers an opportunity for regular hands-on practice within the hospitals. This also helps the team to understand the various roles and responsibilities expected during a full code. Along with continuing education and mock codes, the team members become confident in their responsibilities (Gutwirth, Williams, Boyle, & Allen, 2012).
Bayramoglu, A., Cakir, Z. G., Akoz, A., Ozogul, B., Aslan, S., & Saritemur, M. (2013). Patient-Staff Safety Applications: The Evaluation of Blue Code Reports. The Eurasian Journal of Medicine, 45(3), 163–166. http://doi.org/10.5152/eajm.2013.34
Castelao, E. F., Russo, S. G., Riethmüller, M., & Boos, M. (2013). Effects of team coordination during cardiopulmonary resuscitation: A systematic review of the literature. Journal of critical care, 28(4), 504-521.
Clarke, S., Apesoa-Varano, E. C., & Barton, J. (2016). Code Blue: Methodology for a qualitative study of teamwork during simulated cardiac arrest. BMJ open, 6(1), e009259.
Girotra, S., Nallamothu, B. K., Spertus, J. A., Li, Y., Krumholz, H. M., & Chan, P. S. (2012). Trends in Survival after In-Hospital Cardiac Arrest. The New England Journal of Medicine, 367(20), 1912–1920. http://doi.org/10.1056/NEJMoa1109148
Gutwirth, H., Williams, B., Boyle, M., & Allen, T. (2012). CPR compression depth and rate about physical exertion in paramedic students. Journal of Paramedic Practice, 4(2).
McEvoy, M. D., Field, L. C., Moore, H. E., Smalley, J. C., Nietert, P. J., & Scarbrough, S. (2014). The Effect of Adherence to ACLS Protocols on Survival of Event in the Setting of In-Hospital Cardiac Arrest. Resuscitation, 85(1), 10.1016/j.resuscitation.2013.09.019. http://doi.org/10.1016/j.resuscitation.2013.09.019
Merchant, R. M., Berg, R. A., Yang, L., Becker, L. B., Groeneveld, P. W., & Chan, P. S. (2014). Hospital Variation in Survival After In‐hospital Cardiac Arrest. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 3(1), e000400. http://doi.org/10.1161/JAHA.113.000400
McInnes, A. D., Sutton, R. M., Nishisaki, A., Niles, D., Leffelman, J., Boyle, L., … Nadkarni, V. M. (2012). The ability of code leaders to recall CPR quality errors during the resuscitation of older children and adolescents. Resuscitation, 83(12), 1462–1466. http://doi.org/10.1016/j.resuscitation.2012.05.010
Price, J. W., Applegarth, O., Vu, M., & Price, J. R. (2012). Code Blue Emergencies: A Team Task Analysis and Educational Initiative. Canadian Medical Education Journal, 3(1), e4–e20.
Prince, C. R., Hines, E. J., Chyou, P.-H., & Heegeman, D. J. (2014). Finding the Key to a Better Code: Code Team Restructure to Improve Performance and Outcomes. Clinical Medicine & Research, 12(1-2), 47–57. http://doi.org/10.3121/cmr.2014.1201
Segon, A., Ahmad, S., Segon, Y., Kumar, V., Friedman, H., & Ali, M. (2014). Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital. Journal of Graduate Medical Education, 6(1), 61–64. http://doi.org/10.4300/JGME-D-13-00165.1
Sahin, K. E., Ozdinc, O. Z., Yoldas, S., Goktay, A., & Dorak, S. (2016). Code Blue evaluation in children’s hospital. World Journal of Emergency Medicine, 7(3), 208–212. http://doi.org/10.5847/wjem.j.1920-8642.2016.03.008
Williams, K.-L., Rideout, J., Pritchett-Kelly, S., McDonald, M., Mullins-Richards, P., & Dubrowski, A. (2016). Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses. Cureus, 8(12), e938. http://doi.org/10.7759/cureus.938
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The concept analyzed in this article is nursing care. Evidently, nursing scholars, theorists, and healthcare professions have varying interpretations of the concept. However, in the middle of these disparities, nursing care is a vital aspect of nursing practice and a beneficial factor for both patients and nurses.
Several studies have explored the meaning of the concept (from both nurses and patients perspective) with the aim of identifying the relationship between nursing caring and patient satisfaction. Most textbooks, scientific articles, ethical codes and legal documents use the term nursing as a synonym to caring which are characterized as a nurse’s main ethical obligation (Dalpezzo, 2009).
Therefore, the aim of this concept analysis critique is to help clarify the vague concepts such that every person using it speaks the same thing. This is important in healthcare discipline because it helps people to develop knowledge related nursing concepts.
The overall intention of this analysis to provide a meaningful nursing care concept that can be used by nurse researchers and theorists to get its deeper insights and to identify better means that can be used to assess this complex nursing concept. The specific aims for this concept analysis article critique is; a) to clarify the nursing care concepts, b) identify the strengths of this article in clarifying the nursing concepts and c) to identify the weakness and d) to highlight its implication for practice.
Strengths
The concept analysis criterion background and purpose is clearly described which is to explore the concepts of nursing care and its essence with the aim of developing an operational definition of nursing care (Dalpezzo, 2009, p. 256). Also, the article analyzes the relevant literature to determine the definitions of the nursing care concept terms and in arriving at the core defining attributes of the nursing concept.
For instance, the researcher uses Dictionary.com Unabridged v 1.1, 2006a and the American Heritage Dictionary of the English to define the term ‘care’ and ‘nursing.’ The article also explores the basic definitions of the words ‘caring’ and ‘nursing’ in major nursing models and nursing theories (Dalpezzo, 2009, p. 259).
The author also explores the definition of the concept nursing care from the allied health literature; where he reviewed 16 randomly selected peer-reviewed articles. This research ensured that the analysis of the concept is done extensively, making it clear, distinct and is unambiguously differentiated from the other nursing concepts.
The author develops the definition of the nursing concept in logically, and the discussions of the empirical referents and antecedents are clear. For instance, the author begins by identifying the purpose of the study. This is followed by a brief description of Walker and Avant’s concept analysis method. To start with, the rationale for the selection of the concept nursing care is well outlined which is the lack of clear definition within the nursing literature (Dalpezzo, 2009).
The article describes the purpose of the analysis and clearly identifies the uses of the nursing care concepts in different disciplines. The author also determines concepts defining attributes which include a) nursing care procedures- those needed by patients, b) nature of nursing care – including the high quality of care, nursing skills, safe, holistic and evidence-based, and c) the core functions of nursing care including listening, assessing, preventing, advocating.
The concept is further developed by reviewing additional cases to identify the antecedents and the consequences and to define the concepts empirical referents. This extensive research to define nursing care concept ensures that the analysis of the concept is accurately developed and illuminated (Dalpezzo, 2009).
Weakness
Nursing discipline has set forth an explicit desire to serve the public and commitment to the overall well-being of the society. Therefore, concept analysis is performed to refine the definition of nursing care, with the aim of differentiating it from other similar or dissimilar concepts. The concept analysis of nursing care outlines the focus and boundaries of nursing discipline and also highlights the aspects of the concept that are significant to nursing practice, and can be traced back to the nursing field fundamental concepts(Dalpezzo, 2009).
The terms, meanings, usages, definition and attributes are derived from the nursing care concept analysis is derived from dictionaries, thesauruses, Walker and Avant (2005) method and the current literature. The term nursing care is used throughout the disciplines allied to health, but its meaning is not clear. There are varied themes of nursing care concepts in the literature which present the world’s views and perceptions about nursing care.
However, the concept analysis is limited in that the definition of nursing care concept is a context- based activity; however, the activities differ between the operational environments and the measures or methods used to assess the nursing care outcomes (Koy, Yunibhand, Angsuroch, 2015).
Also, the concept analysis is limited because the attributes gathered from the literature are the only ones used to define nursing care concepts. For instance, the description of nursing care concept from the literature ranges from general conceptions of just being helpful to include divine oriented interventions.
Therefore, the lack of clear definition of nursing care concept in the context of socio-cultural and religious aspects is the greatest dilemma associated with quality nursing practice because it hinders nurse’s efforts to meet patient’s socio-cultural needs. Therefore, future nursing care concepts should put into consideration the cultural contexts (Koy, Yunibhand, Angsuroch, 2015).
Implication for practice
Caring is a complex universal phenomenon and is deeply rooted in the primitive society. For instance, women care for their children and other dependent members of the family. Women involvement in all aspects of care is common in many cultures (Sarpetsa, Tousidou, & Chatzi, 2013). Also, the word ‘nursing’ is highly connected to the term ‘care.’
Nurses deliver nursing care to other people with the aim of maintaining and promoting their health during illness, ordeal or disability. Care is an important element of nursing; and that the conception of the term ‘care’ in nursing affects the way it is delivered. Therefore, people’s perception, experiential, and socio-political aspects of nursing influence provision of care (Schrijvers et al., 2012).
Nursing care is a continuous phenomenon that follows human existence since the time they are born to death. According to Institute of Medicine (IOM) study, nursing care is patient-centric and is directly linked to quality and safety. Nurses have the potential to foster a quality healthcare environment through various ways (Kvist et al., 2014). Nursing care starts with non-verbal communication between the nurses and patients.
It has been found that emotions expressed by nurses towards their patient have an effect on their outcomes, with positive emotions improving their recovery rate. Also, it is through emotional empathy, a respectful, and trusting relationship with the patients is established. Patient-centric care provides a distinct advantage of consistent daily assessment of the patient’s health condition which allows the nurses to detect slightest changes in patients health that require them to proactively make some modifications to the patient care plan when needed (Cheung et al., 2008).
Addressing the variance in nursing care perception is important when interpreting inconsistencies of the concept in nursing literature because it affects patient care outcomes. Nursing care also influences the quality of interaction by the healthcare team (Samina et al., 2008).
While caring is vital between patients and nurses, it is equally important for the healthcare staff because it helps the team to adapt and work together and to understand each person’s individual responsibilities and to provide constructive feedback. Every nurse is a leader because they are in a unique position to make a difference in patient’s recovery. The concept of nursing care facilitates communication, especially when implementing care plans for the patients (Sarpetsa, Tousidou, & Chatzi, 2013).
At administration level, nurses utilize their hands on experience (nursing care) to identify the most effective strategies to delegate the available healthcare recourses to ensure positive patients outcome. Therefore, this concept analysis ensures that one gain the knowledge and technical know-how so that they car skilfully integrate their knowledge into practice (Sarpetsa, Tousidou, & Chatzi, 2013).
Understanding the concepts of nursing care helps one understand the nursing discipline, its culture and the changes needed to make changes that positively impact on the patient’s health outcomes. Tapping into the sufficient knowledge developed by the nursing care concepts analysis, nurses can foster a combination of personal skills, evidence-based practice to collaboratively improve patient outcomes (Schrijvers et al., 2012).
Dalpezzo, N.K. (2009). Nursing Care: A concept analysis. Nursing Forum 44(4); 256- 264
Koy, V., Yunibhand, J., Angsuroch, Y. (2015). Nursing care quality: a concept analysis. International Journal of Research in Medical Sciences 3(8): 1832- 1838 DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150289
Kvist, T., Voutilainen, A., Mäntynen, R., & Vehviläinen-Julkunen, K. (2014). The relationship between patients’ perceptions of care quality and three factors: nursing staff job satisfaction, organizational characteristics, and patient age. BMC health services research, 14(1), 466.
Samina, M., GJ, Q., Tabish, S., Samiya, M., & Riyaz, R. (2008). Patient’s Perception of Nursing Care at a Large Teaching Hospital in India. International Journal of Health Sciences, 2(2), 92–100.
Sarpetsa, S., Tousidou, E., & Chatzi, M. (2013). The Concept of” Care” as Perceived by Greek Nursing Students: a Focus Group Approach. International Journal of Caring Sciences, 6(3), 392.
Schrijvers, G., van Hoorn, A., & Huiskes, N. (2012). The care pathway: concepts and theories: an introduction. International Journal of Integrated Care, 12(Special Edition Integrated Care Pathways), e192.
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Parents have great influences in their children social cognition. For this reason, the eligible participants for this study include adolescents diagnosed with Autistic Spectrum Disorder (ASD), age 16- 23 years and together with their parents or the primary caregiver (Hartley, Schaidle, & Burnson, 2013; Loukas et al., 2015). The inclusion criteria for participants included the ability to communicate in English, and the adolescent is diagnosed with ASD.
Participant recruitment will take place at the community clinical settings. Emails requesting for participation will be sent to the adolescent’s parents/ caregivers diagnosed with ASD. The email will include the project’s description in detail, including the benefits and risks associated with their participation. The parents who are interested in participating will be requested respond to the email and will be contacted for official recruitment processes including the signing of the informed consent
Sample collection is an integral part of research design as it determines whether the research hypothesis will be appropriately tested. Therefore, it is important to establish a balance between an ideal sample and a convenient (Kandalaft et al., 2013). At the commencement of the study, the available study sample is estimated at ten pairs of participants, that is ten adolescents diagnosed with ASD and ten parents/caregivers of the adolescents diagnosed with ASD. However, due to unavoidable circumstances, the study sample may slightly less than the estimated number.
The study sample will be pretested using questionnaires to evaluate the adolescent’s social cognition ability at the baseline. This will be followed by the proposed intervention (training for adolescents and their parents for 15 weeks). After 15 weeks, a post-test and a focus group discussion will be performed to determine the impact of the intervention and to understand the challenges adolescent’s experiences during the transition.
References
Hartley, S. L., Schaidle, E. M., & Burnson, C. F. (2013). Parental Attributions for the Behavior Problems of Children and Adolescents With Autism Spectrum Disorders. Journal of Developmental and Behavioral Pediatrics : JDBP, 34(9), 651–660. http://doi.org/10.1097/01.DBP.0000437725.39459.a0
Kandalaft, M. R., Didehbani, N., Krawczyk, D. C., Allen, T. T., & Chapman, S. B. (2013). Virtual Reality Social Cognition Training for Young Adults with High-Functioning Autism. Journal of Autism and Developmental Disorders, 43(1), 34–44. http://doi.org/10.1007/s10803-012-1544-6
Loukas, K. M., Raymond, L., Perron, A. R., McHarg, L. A., & LaCroix Doe, T. C. (2015). Occupational transformation: Parental influence and social cognition of young adults with autism. Work, 50(3), 457-463.
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Rhetorical Analysis of Amir Attaran’s “The Ugly Canadian”
A Rhetorical Analysis of Amir Attaran’s “The Ugly Canadian”
Thesis
The article, “The Ugly Canadian” aims at convincing Canadians that the government is the tainting the image of the state and correspondingly that there is a gross violation of elementary standards and values both at the national and international level. Likewise, Attaran asserts that Canada is liquidating its internationalism based on the national laws that are showing a dark side of the state. Attaran presents a resounding argument that the government has embraced the concept of “exceptionalism” which has discolored Canada’s progression towards achieving the international honor.
Throughout the article, he dispatches this argument by asserting that the government has taken pride in working in different directions contrary to what the norms profess. For instance, he notes that the abduction of Robert Fowler and Louis Guay; who were Canadian diplomats raised a few eyebrows in spite of them being government envoys. He questions such silence in a distressing manner. He goes further to drive his argument by denoting that the former Prime Minister, Lester Pearson, would never approve the direction the government had taken about its international and national conduct.
Attaran tells of a vast growing evidence of exceptionalism especially within the national context by looking at the legislations and codes of conduct that exist. He gives an indication of foreign trade laws, for instance, the Governor-in-Council gets to decide on which developing countries gets the preference of exporting to Canada at a discounted tariff. Why Attaran asks, does Hong Kong, Israel, South Korea and Singapore get the preference when certainly none of them is poor? (Attaran, 2009).
In further discussion, Attaran points out other wanting areas of concern; public health, corruption and human rights domains. The evidence he gives paints an image of a government that embraces rather than critiquing the loopholes that exist within various systems. Take, for instance, “the state-orchestrated secret kidnapping” which is against the doctrine of enforced disappearance of persons.
Despite Canada having nurtured a global reputation for being a fierce human rights defender, the country is yet to sign UN’s International Convention for the Protection of all persons from enforced disappearance. Attaran pegs this refusal to the fact that Canada is in the actual sense committing the same crimes it should be preventing.
Significantly, by basing his excavation on various domains where the Canadian government has exercised exceptionalism in an arbitrary and unjustifiable way, Attaran delivers substantial evidence as such successfully achieving the intended goal of critiquing the government’ conduct both at the national and international level which has led to tainting the overall image of the country.
By the same token, Attaran further faults the civil society, mainly his fellow academics and NGOs for taking a back seat and failing to question the defects of the government which has led to drift from internationalism. In this respect, Attaran not only attributes the failure to uphold Canada as a respectable nation to the government officials but the society in large. In this way, Attaran successfully conveys his message that the rot affecting the country is deep rooted in the society and if a change is to occur, it should start from the top level going deep down.
Purpose
Arguably, the purpose of the article is not to taint the image of the government but rather to act as a critique towards its international and national conduct which has circumvented the standard codes of practice for a sovereign state. By providing a significant amount of information on various areas where the government has failed, the article provides a weighing scale on which the country can assess itself.
Accordingly, the article also puts the government in the limelight for its various activities. This is an important aspect as it empowers the people to understand various violations conducted by the government. Such an understanding could evoke public disapproval of the activities of the government as such promoting proper change or initiating platforms for facilitating discussions so as to find better ways forward.
Target audience
Notably, Attaran targets the political class at large. These are the people that not only represent the country at the international level, but they also formulate local laws which control the interactions between the citizens themselves, their interactions with various governmental agencies and the state. Arguably, the demeanor of these officials of embracing exceptionalism, which is contrary to conventional norms, trickles down to the society hence causing further adverse effects.
By targeting the political elite, Attaran delivers on his argument that reforms must commence from top most individuals down to the societal members.
Writing strategies
Structure
Notably, Attaran structures the paper in such a way that it allures the reader into developing an interest in the intended goal. He starts off by giving an insight of how two Canadian diplomats were abducted by a shadowy group (Al Qaeda). He further asserts that even though their story has a happy ending, it leaves many questions to be answered.
From this short introductory piece, Attaran can develop his idea of exceptionalism that had been embraced by the government, which had allowed it to deviate from acceptable codes of conduct. He further moves from the international level and gives wide examples of the same concept being applied within the national context. Notably, this structure enables Attaran to develop his story in a smooth manner as he can move swiftly from one issue to another.
Language
Substantially, Attaran sticks to using a formal language throughout the article so as to enable him to deliver his message better. Considering his target audiences are the political elite, it is important that he addresses the issues at hand in a clear manner. Also, by using direct quotations from past scenarios, Attaran can allow the readers to have a flash back to things that they can relate to. This is an upshot to his intended goal as it keeps the reader involved and gives a feel of realness. Also, Attaran uses ridicule and comparison so as to express how Canada has fallen below the expected standards.
The language that Attaran adopts strengthens his argument as he can reach out to his target audience and at the same time connects with the readers
Rhetoric appeals
Expressively, the lack of solid sources to back up Attaran’s claims towards the government’s failures may impact negatively on the intended goal of the article. His focus on technical areas such as security or trade laws without concrete proof on the reasons for the measures taken by the government may not persuade a reader into following his line of thought. Arguably, this forms a weakness for the article; his logos may be questioned especially based on the accuracy of data provided. Also, the historical analogies given may have happened under different circumstances as such making it unfair to put Canada under the same scenario.
Reference
Amir Attaran’, (2009). “The Ugly Canadian” in the Literary Review of Canada.
My clinical role largely involves billing, coding, and documentation of patients’ data to facilitate easy communication between insurance companies and the healthcare organization that I currently work for. My healthcare facility often sends the coding and billing information to insurance companies to claim payments. As a coding, documentation and billing specialist, I am charged with the responsibility of keeping clear health data and reviewing those records before assigning proper codes to specific diagnoses (Benoit, Bergeron and Bertrand, 2016; & Deloitte, 2016).
Coding, billing, and documentation of patients’ health data are governed by strict ethical, legal, and regulatory standards because they involve usage of confidential information. In this regard, clinicians have strict ethical and legal responsibilities to observe as far as documentation strategies, coding, and billing are concerned (Benoit, Bergeron and Bertrand, 2016).
Personally, I feel that it is in order for documentation strategies, coding, and billing to be governed by strict ethical, legal, and regulatory standards. Since clinicians have access to private patient’s records, they must maintain total confidentiality in their documentation strategies, coding, and billing (Deloitte, 2016). In addition, these clinicians have an ethical responsibility to access only that information that is related to the issue being addressed at any given time.
Their actions must comply with the ethical standards documented in the American Association of Professional Coders and the American Health Information Management Association (Benoit, Bergeron and Bertrand, 2016). As far as their legal and regulatory responsibilities are concerned, documentation, coding and billing specialists must maintain confidentiality requirements as outlined in the Health Insurance Portability and Accountability Act, (HIPAA). The ethical, legal, and regulatory standards that govern documentation strategies, coding, and billing, play a significant role in minimizing healthcare fraud and abuse (Deloitte, 2016).
Evidence-based research has become an important aspect of the healthcare industry in the recent past due to the role that it plays in improving healthcare delivery. According to JoAnn (2017), evidence-based research is necessary because it helps clinicians to generate the right type of data that they can use to improve the effectiveness of care. Clinicians often rely on different kinds of knowledge for them to make the right decisions in their relationships with sick patients.
Furthermore, they are expected to have a comprehensive understanding of the physiological, psychological, emotional, and social factors affecting their patients’ health for them to deliver the most appropriate care. Although clinicians can quickly obtain this information from existing literature, they must complement it by evidence from empirical research. Evidence-based research, therefore, provides clinicians with practical facts that they can integrate with their experiential knowledge to improve patient care (Kristensen, Nymann and Konradsen, 2015).
I incorporate evidence-based research to a large extent into my role as a clinician. I firmly believe that the safety of my patients depends on the availability of evidence that can adequately support the nature of care that I deliver to them (JoAnn, 2017). For this reason, I rely on data obtained from evidence-based research to improve healthcare services which serve to promote better outcomes for my patients.
I do not only rely on evidence-based research to change my care practices, but I also develop available evidence to fulfill existing knowledge gaps as far as improvement of patient safety is concerned. Over the coming years, I aspire to utilize evidence-based research to improve my skills as a clinician (Kristensen, Nymann and Konradsen, 2015).
Falls are common among seniors, especially those who are suffering from chronic health problems such as diabetes (Graveande and Richardson, 2016). According to Graveande and Richardson (2016), a geriatric fall is a sudden occurrence among the elderly that signifies a decline in their homeostatic reserve. Geriatric falls pose a great risk of loss of independence to the elderly in the society today.
This calls for the greatest need to identity and implements the most appropriate health maintenance strategies that would improve care for this population and their families. Mazur, Wilczynski, and Szewieczek (2016) critically explore the importance of health maintenance specific to geriatric falls as it pertains to the care of the patient and their family.
According to Mazur, Wilczynski, and Szewieczek (2016), exercise is the most appropriate health promotion strategy for geriatric falls because it helps to improve balance and minimize the risks of repeated falls. Exercise is a recommended health promotion strategy for geriatric falls because it serves to generate a greater amount of homeostatic reserve for the elderly patient. In addition to exercise, elderly patients who are at high risks of falling should eat a balanced diet as this provides them with energy that they may need to regain physical activity.
As Mazur, Wilczynski and Szewieczek (2016) explain, social support can help to reduce risk factors for future falls among the seniors because it drives away the fear that typically develops from past falls. Family members of elderly patients who are recovering from the effects of falls should pay attention to physical activity, nutritional strategies, and social support in their effort to promote positive health outcomes for their patients (Mazur, Wilczynski and Szewieczek, 2016).
I agree with the solutions provided by Mazur, Wilczynski and Szewieczek (2016) because they are supported by evidence-based research. In a well-organized research, Burton, Cavalheri and Hill (2015) have revealed that physical exercise programs help to improve balance in older adults who are at risk for falls. These researchers further assert that planned nutritional strategies contribute to induce positive health changes such as improved performance and reduced risk for falls in geriatric patients.
In a similar study, Durbin, Kharrazi and Mielenz (2016) support the use of social support, physical exercise, and dietary supplements in promoting health maintenance to geriatric patients. Since health maintenance solutions for geriatric falls are supported by evidence-based research, clinicians can utilize these ideas to make appropriate healthcare decisions for their elderly patients (Kristensen, Nymann and Konradsen, 2015).
The number of elderly adults who are being diagnosed with diabetes in the society today is on the rise. The major challenge faced by clinicians is defining the therapy goals for geriatric patients due to the existence of limited data about the aging process and drug response of this population (Kazerle, Shalev, and Barski, 2014).
Considering the complexities that surround the health status of geriatric patients, clinicians are charged with the responsibility of choosing a treatment plan that will maximize glycemic control, while at the same time avoiding exposing their patients to increased risks. Due to variations in physiological functions between adults and geriatric patients, the treatment approach for geriatric patients differs significantly from that of an adult (Graveande and Richardson, 2016).
Treatment of geriatric patients involves the use of medication as well as other interventions such as nutritional strategies and psycho-social support (Graveande and Richardson, 2016). This paper will focus on pharmacological or drug treatment alone. The best medication that should be used to treat geriatric diabetic patients includes; metformin, sulfonylureas, meglitinides, thiazolidinediones, alpha-glucosidase inhibitors, dipeptidyl peptidase-4 inhibitors, and sodium glucose co-transporters two inhibitors.
These medications are taken orally at highly controlled doses. Geriatric diabetes patients can also be treated using injectable therapies such as GLP-1 analogs, pramlintide, and insulin. Although similar medications can be used to treat diabetes in adults, the drug dosage differs significantly between the two populations due to variations in pharmacokinetic parameters. In this respect, the drug dosage given to geriatric patients are relatively lower than those administered to adults. The goal of delivering lower doses to geriatric patients as compared to adults is the need to maximize chances of glycemic control, without exposing the elderly adults to additional risks (Kazerle, Shalev, and Barski, 2014).
My learning progress in the course directly correlates to the stages in Benner’s Novice to Expert Theory. Benner’s Novice to Expert Theory assumes that a learner experiences a progressive form of knowledge acquisition that involves five stages namely; novice, advanced beginner, competent, proficient, and expert stages of skill acquisition (Josephsen, 2014). Since I began the course, I have successfully gone through the first stage of Benner’s theory known as novice stage.
When I started the course as a novice, I had no background experience, and I had difficulty differentiating between relevant and irrelevant aspects. Even now, I still take my time to understand course requirements and their significance in shaping my roles as a clinician. After familiarizing myself with a few course concepts, I will move to the second stage of advanced beginner.
At this stage, I will rely on rules provided by my instructor to perform every individual task. Furthermore, I will ask more experienced students to help me integrate practical knowledge and to set priorities for the course (Bowen and Prentice, 2016).
After learning course concepts for two years, I will progress to the competent stage of skill acquisition. Here, I will easily compare situations and make judgments on that scenario that require immediate attention. Additionally, I will integrate devised rules with those learned in the classroom to help solve complex matters. From the competent stage, I will move to proficient stage characterized by critical thinking and individual decision making (Bowen and Prentice, 2016).
While at proficient stage of skill acquisition, I will be able to easily see changes that take place in every situation and implement appropriate responses to promote success. It is at this stage where I will view the course as a whole rather than regarding its small components like I currently do. Later on, I will progress to expert stage of skill acquisition. Here, I will be able to grasp every situation more accurately than now.
Additionally, I will no longer rely on rules and guidelines to make appropriate decisions on how to tackle issues related to the course. Moreover, I will operate from a deep understanding of every situation and make judgments that will generate positive outcomes (Josephsen, 2014).
In conclusion, as a clinician, I have an obligation to observe ethical, legal, and regulatory responsibilities during documentation, coding, and billing. Also, I must acknowledge the importance of evidence-based research by making clinical decisions based on facts obtained from empirical studies. A good example of a health situation in which I can effectively utilize evidence-based research is when designing a health promotion program specific to geriatric falls.
In this case, evidence-based practice will help me to deliver the most appropriate care for the patient and his or her family. Considering the little volume of knowledge that I have gathered as a novice, I believe that my learning progress in the course effectively correlates to the stages of Benner’s Novice to Expert Theory.
References
Benoit, M., Bergeron, J. & Bertrand, G. (2016). Decision-making tool: Telepractice and digital records management in the health and human relations sectors. Quebec: Conseil Interprofessionnel du Quebec.
Bowen, K. & Prentice, D. (2016). Are Benner’s expert nurses near extinction? Nursing Philosophy, 7(2): 144-148. Doi.10.111/nup.12114.
Deloitte. (2016). International review: Secondary use of health and social care data and applicable legislation. Author: Deloitte & Touche Oy, Group of Companies.
Durbin, L., Kharrazi, R. & Mielenz, T. J. (2016). Social support and older adult fall. Injury Epidemiology, 3(1):4.doi:10.1186/s40621-016-0070-y
Grave and, J. & Richardson, J. (2016). Identifying non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus: A systematic review. Disability and Rehabilitation, 39(15): 1459-1465.doi:10.1080/09638288.2016.119974.
JoAnn, M. (2017). Call to action: How to implement evidence-based nursing practice. Nursing, 47(4):36-43.
Josephsen, J. (2014). Critically reflective theory: A proposal for nursing education. Advances in Nursing, 2014: 360-594. Doi:10.1155/2014/594360.
Kazerle, L., Shalev, L. & Barski, L. (2014). Treating the elderly diabetic patient: Special considerations. Diabetes Metabolic Syndromes and Obesity, 7: 391-400.
Kristensen, N., Nymann, C. & Konradsen, H. (2015). Implementing research results in clinical practice: The experience of healthcare professionals. BMC Health Services Research, 16:48.doi:10.1186/s12913-016-1292-y
Mazur, K., Wilczynski, K. & Szewieczek, J. (2016). Geriatric falls in the context of a hospital fall prevention program: Delirium, low body mass index, and other risk factors. Clinical Interventions in Aging, 11:1253-1261.doi:10.2147/CIA.S115755.
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