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Use of Chlorhexidine Bath to Reduce (CLABSI)

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Use of Chlorhexidine Bath to Reduce Central-Line Associated Bloodline Infections (CLABSI)

The study on the impact of daily use of chlorhexidine bath on the outcomes of ICU adult patients with central-line associated bloodstream infection guided by the PICOT question: In adult patients in Intensive care units (P), does daily use of chlorhexidine bath (I) compared to the use of ordinary soap and water (C), decrease the central-line associated bloodline infections (O), in a period of six months?

An understanding of the effect that chlorhexidine bath can have on improving patients’ outcome is an impact to nursing care and can serve as evidence to nursing practices. Poor nursing practices have adverse effects on patient’s outcomes and results to long hospital stay duration, which is associated with more other risks and complications. Investigation of the best practices on CLABSI, a condition whose outcomes is greatly dependent care is an important thing as it will better the care practices.

Findings

The results of the inquiry are in tandem with the proposition of implementation of chlorhexidine bath as a means in washing intravenous ports to control CLABSI. Results of the study undertaken indicate a decline in rates of infections due to the use of chlorhexidine bath are significant evidence for its adoptions. In investigating the outcomes of the impacts of chlorhexidine, some studies were used, all of which gave valid evidence that indicated a positive result in adult CLABSI patients.

From the systematic reviews and other studies, it was reported that the use chlorhexidine bath in the management of infections is one of the most essential intervention. Systematic reviews linked the application of chlorhexidine bath as an approach of minimizing the level of HA-CLABSI as well as association health care and medication costs.

A systematic review (Karki, & Cheng, 2012), realized that use of non-rinse CHG application has a positive impact as it substantially lowers the risk of CLABSI, SSI, and colonization with VRE or MRSA. Another study (Kim et al., 2016), which was conducted to investigate the effect the effects chlorhexidine bathing in CLABSI also gave a similarly positive conclusion. Kim et al. carried out peer reviews and meta-analyses, which indicated that use of chlorhexidine on a daily basis reduced the incidences of CLABSI, MRSA, and VRE to a great extent (2016).

In addition, Kim et al. found out that the extended use of the approach improved patient outcomes. While conducting investigations using the same variables, a randomized controlled study on the effects of chlorhexidine bath interventions hospital-acquired infections, (Wong et al., 2013) gave positive findings linking the two. Wong et al., states that a daily use of washcloths impregnated with chlorhexidine protected patients from acquiring MDROs and central-line associated bloodstream infections.

Many other studies (Cullen et al., 2016; Denny 2016) reviewed gave additional evidence that supported the use of the intervention in reducing chances of the concurrence of hospital-based conditions and other conditions. The meta-analysis study conducted by (Cullen et al., 2016) found out that using 2 % chlorhexidine lowered the incidences of central-line associated bloodline infections. Moreover, by this mediation, this study reports that related costs of care are decreased by 10% as compared when there are no such interventions.

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Impact

The research will have positive results in the sense that it will provide pieces of evidence that will be used to trigger changes in health care practices. Findings from this study will be used to disprove poor practices which affect patients’ outcomes. As seen from some of the studies, besides improvement of patient’s outcomes, it is also evident that the intervention can improve the whole healthcare system as some of the unnecessary costs due to complex conditions, and increased hospital stay will be dealt with.

The effect of this intervention will imply that there will be decreased cases of CLABSI, BCC among other conditions. If this intervention is not practiced, then hospital stay duration for patients may be increased and an ultimate increase in the cost of their medication. Generally speaking, without the evidence-based practice, then CLABSI incidences will continue being high as well poor patient outcomes.

Strategy: Implementation and Challenges

The model can be used in the implementation is the Stetler model which is made up of five stages (Stetler et al., 2007; Aarons, Hurlburt, & Horwitz, 2011), all the parts in this model are designed to allow for critical thinking on the issue of implementation. The model is also a vital tool in minimizing errors in practice. Use of Stetler model in executing chlorhexidine bath will involve the following phases which will be crucial as a requirement of the design.

Phase 1 (preparation for implementation of Evidence Based Intervention): The aim of this approach could be sited as use of chlorhexidine bath in patients in various patient care settings with the aim of decreasing the rates of CLABSI. In this stage, activities that will be used in support of this evidence-based practice will involve the systematic review randomized studies, the quasi-experimental intervention study, and the prospective multivariate study. In the preparation stage, factors that have the ability of affecting the implementation process such as nurse commitment are needed for best practice.

Phase two (validation): All the evidence and studies chosen to support evidence will be analyzed individually to confirm their suitability and credibility to use in enhancing the use of disinfection caps in the management of CLABSI. This process will be essential for determining the strength of the evidence and will be used in finding whether or not to use evidence from such sources for the preparation of the evidence-based practice.

Phase Three (Comparative evaluation): From in depth study of the various articles chosen for this research, it was noted that they have a great index of resemblance, considering the contents of PICO question. Though different designs were used, they managed to measure the impact of chlorhexidine bath on the incidences of CLABSI. Moreover, study population addressed was the adults. At this juncture, the possibility of the intervention will be chosen by use of triple ‘r’ Stetler’s concept in which provision of necessary resources, risks and willingness of other stakeholders such as nurses and doctors will be considered before launching on the evidence-based intervention.

Phase Four (Translation): This will involve a process that is written down on how the implementation process of using chlorhexidine bath will be used to promote the control of CLABSI.

Phase Five (Evaluation): The results of the evidence-based practice will be assessed in various ways. In most cases, this will be achieved by records or a realization of a decreased number of CLABSI and associated conditions.

The preferences and values of other persons including nurses and patients may accelerate or hinder the process. It is as indicated in the Stetler’s model of EBP in third phase where r’ r’ r’ concept is applied. The Evidence-based practice will not be achieved if the resources (R). Also, if other stakeholders are not ready(R) to adopt the approach, then it will not be easy for it to take root.

Lack of enthusiasm from both nurses and patients may pose as a challenge to the project in that clinicians are required to aid in executing it, so that when they object, they will adhere to their standard practice. Some patients have autonomy rights that prompt them to decline some forms of medical procedures. Therefore, the best way of overcoming implementation challenges will include convincing other healthcare workers and ensure that the practice is well funded and supported by stakeholders.

Project Summary

This research entails collection of evidence that will be used to guide practices in nursing and healthcare as a whole. It focuses on investigating the impact of using chlorhexidine baths to reduce incidences central-line associated bloodstream infections and others conditions that are hospital-based. The project examines different types of researches, be it single-quantitative researches, systematic reviews, meta-analyses and other types of evidence.

To complete this project, research will be limited to the PICOT research question: In adult patients in Intensive care units (P), does daily use of chlorhexidine bath (I) compared to the use of ordinary soap and water (C), decrease the central-line associated bloodline infections (O), in a period of six months?.

Others studies carried on CLABSI, which will not address all these components will not be used as evidence to validate or disprove the intended intervention. Evidence will be gathered from studies that involve adult patients under intensive care or other high risks levels of care. In carrying out this inquiry, outcomes will be compared against that of patients who will not be under intervention programs.

Carrying out this survey is an important thing to healthcare practices in the sense that it will collect enough evidence that will be used to guide care practices so that there is an ultimate improvement in patient outcomes. Further, this research intends to find valid information that will be used to reduce the standard practices such as the use of water and soap, which have proved hurtful to patients’ outcomes.

References

Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4-23. Retrieved from http://link.springer.com/article/10.1007/s10488-010-0327-7.

Climo, M. W., Yokoe, D. S., Warren, D. K., Perl, T. M., Bolon, M., Herwaldt, L. A., & … Wong, E. S. (2013). Effect of daily chlorhexidine bathing on hospital-acquired infection. The New England Journal of Medicine, 368(6), 533-542. doi:10.1056/NEJMoa1113849

Denny, J. (2016). Chlorhexidine Bathing Effects on Health-Care-Associated Infections. Biological Research for Nursing.

Karki, S., & Cheng, A. C. (2012). The impact of non-rinse skin cleansing with chlorhexidine gluconate on prevention of healthcare-associated infections and colonization with multi-resistant organisms: a systematic review. The Journal of Hospital Infection, 82(2), 71-84. doi:10.1016/j.jhin.2012.07.005

Kim, H. Y., Lee, W. K., Na, S., Roh, Y. H., Shin, C. S., & Kim, J. (2016). The effects of chlorhexidine gluconate bathing on health care-associated infection in intensive care units: A meta-analysis. Journal of Critical Care, 32126-137. doi:10.1016/j.jcrc.2015.11.011.

Shah, H. N., Schwartz, J. L., Luna, G., & Cullen, D. L. (2016). Bathing With 2% Chlorhexidine Gluconate: Evidence and Costs Associated With Central Line-Associated Bloodstream Infections. Critical Care Nursing Quarterly, 39(1), 42-50. doi:10.1097/CNQ.0000000000000096

Stetler, C. B., Ritchie, J., Rycroft-Malone, J., Schultz, A., & Charns, M. (2007). Improving the quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change. Implementation Science, 2(1), 1. Retrieved from https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-2-3.

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Generalist Practices: A Case Study of Brenna

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Generalist Practices: A Case Study of Brenna

Introduction

According to Langer & Lietz (2015), generalist practices refers to the sociological concept, which defines the general guideline for carrying out the social work. The new individuals are introduced into some of the concept considered significant in improving their lives. Langer & Lietz (2015) avers that some of the sociological activities stressed on during the implementation of generalist practices include the promotion of the welfare of a human, as well as the application of the intervention and preventive measure to different social challenges and also problems affecting an individual (Langer & Lietz, 2015).

Here, ethical principles and practices, as well as the critical thinking are some of the issues taken into considerations. Therefore, this paper will seek to identify how generalist approach has been employed in the Brenna’s case study.

Three Examples of Generalist Practices Depicted in Brenna’s Case Study

First, it is worth noting Brenna is a victim of dating abuses, as well as domestic violence. As a result, she was subjected to a very difficult life, after falling out with her mother, as she was not even able to complete her education (Working with Survivors of Sexual Abuse and Trauma, n.d). Soon after she became pregnant, her boyfriend, Cameron, denied he was the father of the unborn, forcing Brenna to live in deplorable shelter in order to give birth. Thus, she had to undergo through the generalist practices to restore her life back to normalcy. Some of the three generalist practices applied in this case are listed below.

First, the social work manager helped Brenna to set up her goals in issues such as attaining financial stability, medical care, and permanent housing. Secondly, the manager assisted Brenna in advancing her education by facilitating her enrolment in the GED, ‘General Education Development,’ training (Working with Survivors of Child Sexual Abuse, n.d.). Thirdly, the social worker also encouraged her to undertake therapeutic sessions in order to raise her self-esteem.

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General Characteristics That Validate These Examples to Be Regarded As Generalist Practices

The first practice, concerning helping Brenna set her goals, was very important. Some of the characteristics that validate it as a generalist practice include; the social worker helped Brenna become eligible and be approved for the Medicaid services (Working with Survivors of Child Sexual Abuse, n.d.). The worker also helped her get her residence. The next practice can be validated based on the facts that Brenna was able to join GED in order to advance her education (Working with Survivors of Sexual Abuse and Trauma, n.d).

She also benefitted through attaining a new and beneficial network from other single mother she met. Thirdly, her decision to attend the therapeutic session enabled her attain resilient and overcome her fears and worries in life. As such, she was able to set up difficult life goals.

The Effectiveness/Ineffectiveness of Each Example In Terms Of Benefits to the “Client”

The first practices, concerning attaining her life goal, was very effective. This is due to the fact that Brenna was able to get the approval on accessing Medicaid services. Furthermore, she was also able attend prenatal services when she was still pregnant. Moreover, she was also able to secure a well-furnished house. Secondly, Brenna was able to attend GED, thus, improving her education.

This can be validated by the fact that she was able to make informed decisions such as sticking to the proper nutritional practices and budgetary measures (Working with Survivors of Sexual Abuse and Trauma, n.d). Lastly, her decision to attend the therapeutic sessions enabled her feel free to make a new beginning in life. She was also to set her goals without informing her former boyfriend, Cameron.

References

Langer, C. & Lietz, C. (2015). Applying theory to generalist social work practice: a case study approach. Hoboken, New Jersey: John Wiley & Sons, Inc.

Working with Survivors of Sexual Abuse and Trauma (n.d). The Case of Brenna. Social Work Case Studies: Foundation Year, 31-33, 107-104.

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Biomechanics on Basketball Jump Shot

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Biomechanics on Basketball Jump Shot

How to Make a Jump Shot Effectively

The jump shot technique is one of the essential elements of the techniques of basketball as it allows the players to earn points. The technique requires high level of performance and it engages the legs without the ball followed by a counter movement short of an arm swing. To effectively enact the move, it is important that the player should learn the fundamentals of the technique. To master the move the player ought to start with the necessary and proceed to learn the more sophisticated techniques following intensive practice and training.

The first step in ensuring that the move is conducted efficiently, the player has to select a comfortable location. In so doing the player should turn the body to face the hoop and subsequently plant the feet on the ground. More so the feet should be set in such a way that they are 10- 45 degrees such that the hips, shoulders, and elbow are aligned with the basket. In the second step, the player should get in a shooting position also known as the shooting stance. The stance has a significant impact on the accuracy of shooting. The knees should then be flexed slightly to allow for flexibility. Also, this is the position that powers the jump. The foot positioning, in this case, should be shoulder width to enhance the shooting speed.

In the third position, the ball is raised into the shooting position. To effect the position, the ball is dipped to the shooting side. The fingers should be spread to ensure that the player has control of the ball. The shooting hand should be placed behind the ball such that the back of this hand is aligned directly away from the basket. The non-shooting hand, on the other contrary, should be positioned in such a way that is on the side of the ball. Additionally, the thumb on the non-shooting hand should point towards the forehead.

The next step of the jump is to flex the knees and then make the jump. The player ought to push with their hips and legs so as to launch themselves into the air. To ensure maximum accuracy, it is important to keep the forearm aligned vertically when flexing so ensure that the motion is in line with the hoop. As the player jumps, they should launch the ball up in front of the body towards the basket in the arc with the shooting arm first.

Subsequently, the shooting arm elbow should be straightened as the player shoots. The shooting hand should only be used to ensure that the ball is kept in control. At the top of the jump, the ball is released by turning the wrist downwards. Consequently, the ball is expected to roll off from the shooting hands having contact with the index finger last. After the ball is shot the shooting hand should then naturally descend.

The Biomechanics Principles of the Jump Shot

While making the shot, various biomechanical principles have been shown to maximize the accuracy of the shot while imparting sufficient power. Regarding precision and power, several biomechanical principles are linked to the effectiveness of the jump. It is evident that here is production of a force that the shooter will employ so as to begin the shooting motion.

Research indicates that the force is produced by the activity of the muscles (Struzik, Pietraszewski & Zawadzki, 2014). As a result, the stronger the muscles, the more power will be produced. However, it is important that the force developed by the muscles or the groups of the muscles must be applied in the proper sequence as well as in the proper direction so as to ensure that the greatest force is realized muscles (Struzik, Pietraszewski & Zawadzki, 2014).

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As a result, there is the derivation o the most important principle of biomechanical power which is known as the summation of forces. The principle provides that the shooter should apply all the forces of summation. As such to impart the greatest power it is important that the shooter should gather the fore beginning from the legs heading to the fingertips as they release the ball. As more power is added to each and every muscle group, the shooter will be able to push the ball further than if the individual muscles were applied muscles (Struzik, Pietraszewski & Zawadzki, 2014).

Another aspect that enables the shooter to have a mechanical advantage by facilitating a range of motion speed as well as the strength. As such as when shooting the basketball, the shooting arm should act as the lever and therefore assist in increasing the power of the shot. In this case, the lever will help them in guiding the ball to get off the middle, and the index finger as the shot is completed (Struzik, Pietraszewski & Zawadzki, 2014).

However, the lever should also be used effectively to ensure that the shot is done effectively. Most importantly, the position of the hands during the delivery is also important to allow the ball to fly off the hands with the perfect backspin.

Another biomechanical aspect that is important in the accuracy of the shot is the angle of projection. It is implied that when the greater the angle of projection is high, then the object is likely to obtain a greater vertical height (Struzik, Pietraszewski & Zawadzki, 2014). On the contrary, if the angle of projection is small, then it is likely that the ball will not have sufficient vertical velocity to have the sufficient range.

Similarly, it is evident that the release angle and the entry angle are correlated. As such when the entry angle is reduced, the target size is also reduced. The best yielding angle of release is the one that is shot between 50 and 70 degrees (Struzik, Pietraszewski & Zawadzki, 2014).

The objective of all the players during the game is to score points. As such the player has to be endowed by various techniques such as jump shots. The technique is one of the most popular techniques that engages the player in a two-legged jump shot.

The technique is not as simple as it appears since the movement ought to be automated such that the player achieves the required elements of biomechanics. The most important variables to be considered in the jump shot includes the angular velocity, the release angle and the angle and power of the portion of the body of the shooter. Therefore, the motor abilities of the shooter also plays a significant role in enacting the shot effectively.

References

Struzik, A., Pietraszewski, B., & Zawadzki, J. (2014). Biomechanical Analysis of the Jump Shot In Basketball. Journal of human kinetics, 42(1), 73-79.

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How Organizational Structures Support or Impede Innovation

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How Organizational Structures Support or Impede Innovation

Organizational structures acts as the main guideline of how to run activities like supervision, coordination and task allocation. Also, it defines the flow of information in diverse levels of management (Swan, 2007, P. 177). On the other hand, innovation entails changing the organization’s processes or coming up with new ideas to improve the company’s performance.

Therefore, for change to take place, the organizational structures should be active to avoid confusion. Moreover, the management should have a positive attitude to embrace changes which occur as a result of the transformation process. Innovation depends on the employee’s flexibility, adequate information and communication systems and proper project management.

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For change to be effective, people should have knowledge about various matters. According to the epistemology of possession, knowledge is a personal property of an individual, who interprets the meaning of data according to perceptions, experiences, and previous understanding. Various people with different past experiences are likely to draw different conclusions from the same information. Since knowledge is based on an person, what individuals agree on as true is driven by those in power since their justifications often have a lot of weight.

For instance, in western medicine, clinicians who claim about the best treatments, basing their knowledge on scientific research override the competing claims which come from less powerful groups applying alternate therapies (Newell et al., 2009, P. 15). The sales persons can use support innovation by sharing ideas from customers because they are in a position to understand the customers’ needs. These thoughts help the organization to come up with better products to suit the market’s needs.

Additionally, the firm tries hard to maintain a fairly flat organizational structures to avoid many rules and regulations. Moreover, the firm did not have a human resource department, and would employ its workers formally through the word of mouth. These features help in recruiting the most competent workers because recruitment considers a person’s ability to apply his knowledge in diverse areas. Moreover, the organization ensures that there are adequate resources for implementing in all technologies to facilitate project implementation.

Organizations use ICT to carry out knowledge work. However, the human agency, physical properties of some ICTs and institution within which the people make their work influence the effect of ICT on education. Research shows that technology determines the type of organizational structure.

The organizational structures have the ability to support or impede innovation in some ways. Change starts with the management of awareness that different people possess. If workers conduct the improvements appropriately, people will learn to embrace and apply the change correctly (Camison & Villar-Lopez,204, P. 100).

References

Camisón, C. and Villar-López, A., 2014. Organizational innovation as an enabler of technological innovation capabilities and firm performance. Journal of Business Research, 67(1), pp.2891-2902.

Swan, J., 2007. Managing knowledge for innovation. In Rethinking knowledge management (pp. 147-169). Springer Berlin Heidelberg.

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Establishing an effective POLC Framework

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Establishing an effective POLC Framework

Introduction

Outdoor recreation or activity refers to the pursuit of leisure activities that appeal to the lovers of natural or unnatural activities in remote village settings or towns. These are largely team sports that attract hardened individuals who are risk takers and love challengers. The sporting activity maybe canoeing, waterskiing, rock climbing, surfing, fishing, hunting, sailing or even horseback riding among other sports events.

The management of such an event provides a complex test of organization skills and a web of complicated decision-making that stem from clear understanding of business operations. The complex situations demands for skillful and competent managers who have clear business strategies and vision for successful business operations (Davidson & Stebbins, 2011).

The management of Outdoor Adventure Paintball Park (Outdoor Adventure) and as per the wishes of the three family members, who own the company but are not experienced on handling complex outdoor sporting activities, seeks to establish an effective POLC framework. The company strategically resolved to:

1). Reaffirmed the need to develop and share a strong and motivating mission statement.

2). Change the personnel in charge of resource organization

3). Implement new measures to ensure effective training of manpower, recruitment and development of sound employment policies and job descriptions (Miska & Mendenhall, 2015).

4). Find new ways of improving leadership and motivating employees to work hard.

5). Enumerate the critical aspects of adopting measures of standard performance, balance score cards and effective feedback systems that reflect the company’s vision and mission.

6). To implement the POLC framework and weigh its impact on organizational growth.

Planning

Mission and Vision

The mission of the outdoor facility is to provide fun activities that are safe and which are designed to enhance rich outdoor experience for children, teenagers, young adults, team building work groups that target relaxation and also holiday making. The vision of the facility is to provide unrivalled Outdoor experience that would be an entertainment destination for thousands of professions throughout the country and other fun lovers. The number of visitors currently visiting the facility out-numbers the resources available and mishandling of customer bookings have been noted severally due to staff incompetence and lack of clear operations structure. The result has been loss of potential customers and sales.

Goals, Objectives and Strategy

The company seeks to develop and set goals that are consistent with the management strategies as espoused by the company’s mission and goals. The operations of the company have been organized to develop targets that would ensure that the goals of the company have been achieved. The Outdoor Adventure’s management team has ensured that the operational strategies that had been earmarked to improve performance have been fully implemented in an effort to increase sales and improve customer experiences. The strategies are addressed during the initial POLC framework planning to ensure that the crucial concepts are also captured in the POLC framework.

Organizing

Organization Culture

Outdoor Adventure was established b three owners who shared a dream of developing a first class outdoor facility that would provide memorable experiences to all its customers. However after several years in existence the owners are not on the same page regarding the management of the Outdoor sports center. The management wants to institute a new organization culture that would enhance more team work and create more production and sales.

Organization Structure

The organization lacks a clear organization structure which is making the company to be ineffective in its role as a first class facility. The current structure provides no job definitions or roles. The company needs to adopt a clear organization structure that has clear hierarchy order as depicted below. The major advantage of hierarchal organization structure is that it provides an appropriate centralized structure that is consistent with the nature of the business that needs a strong management presence in most of its operations.

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Job Profiles, Descriptions and Responsibilities

John Thomas oversees most of the company’s general operations and is also responsible for making key organizations changes and business operations. Carl Thomas is also responsible for general business operations together with Joe.

Phillips is responsible for daily operations at the company while also coordinating and assigning duties at the park. Roberts is in charge of sales and marketing and works directly under the three directors. Finesse is in charge of the human resource and is responsible for hiring competent staff. The stores department is manned with Smith who also oversees the work of other store’s supervisors while also controlling the inventory. She reports to Phillips. The concepts of POLC are meant to equip the organization with qualified personnel who can steer the company in the right direction.

Leadership

The lack of a clear organization structure in Outdoors Adventures led to ineffective leadership which also trickled to other departments and eventually affected the customers (Miska & Mendenhall, 2015). Poor communication among the owners resulted in ineffective business operations. To promote innovation at the park, the management ought to consider knowledge-based leadership as a way of promoting innovation (Doh and Quigley, 2014).

Knowledge based leadership would provide better and well informed judgment on the part of the three owners given that some employees are concerned on what are the real objectives of the park from the owners perspective. Leadership skills form one of the major components or pillars of POLC framework (Conway, n, d).

Control

Balanced Scorecard

The best way to implement strategic controls in a company is through the use of balance scorecard that has aligned the four major functions with the company’s strategy that has also incorporated the company’s mission and vision. The balance scorecard (BS) translates a company’s vision and strategy into reality.

The BS identifies the relationship between a company’s operations control and the strategic controls of a company. What the customers are exposed and what the management wants the customers to see. How the company’s financial resources match the shareholders expectations and the best way to grow (Kaplan & Norton, n, d).

Strategic Human Resource Management

The human resource management plays a critical role in POLC framework. The HR department must hire competent employees to ensure that the services provided by the company are above the average standards and qualities of all the company’s services are universally acceptable and are consistent with the company’s objective.

References

Conway, C. (n, d) Leadership Skills Approach retrieved July 11, 2016 from http://users.jyu.fi/~naabouck/paper/Leadership_Chapter3.pdf

Davidson, L., & Stebbins, R.A. (2011) Serious Leisure and Nature: Sustainable Consumption in the Outdoors. Hound mills, UK: Palgrave Macmillan.

Doh, J. and Quigley, N. (2014) Responsible Leadership and Stakeholder Management: Influence Pathways and Organizational Outcomes. Academy of Management Perspectives, 28(3), pp.255-274.

Kaplan, R.S. & Norton, D.P. (n, d) Putting the Balanced Scorecard to Work, Harvard Business Review, retrieved July 11, 2016 from https://web.archive.org/web/20140202115133/http://www.theclci.com/resources/5HBR-PuttingTheBalancedScorecard.pdf

Miska, C., & Mendenhall, M.E. (2015) responsible Leadership: A Mapping of Extant research and Future Directions, Journal of Business Ethics retrieved July 11, 2-16 from http://link.springer.com/article/10.1007/s10551-015-2999-0

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Unethical Practice by Computer Sciences Corporation

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Unethical Practice by Computer Sciences Corporation

Ethics & Finance Paper

Introduction

This paper discusses one of the most significant illegal and unethical practice which had been caused by Computer Sciences Corporation for which the company and its management was also charged by the US government. This is known as the Medicaid fraud under which the company had been involved in two fraudulent schemes. Both of these schemes had used the computer programs for circumventing the requirement that once the private insurance coverage becomes exhausted then only the billing of the Medicaid should be performed (Office, 2014).

Along with these two schemes, the third fraud scheme focused on the use of the defaulting. Under this scheme the company had falsified all the diagnosis codes which had been submitted systematically to Medicaid. This paper analysis this issues with specific emphasis on Sarbanes Oxley Act 2002.

Mistakes made by Computer Sciences Corporation

The main problem of Computer Sciences Corporation is that the company has good people but they all are poorly managed. The employees of the company are rated by those people who do not work with the employees on a regular basis. The appraisers at Computer Sciences Corporation are not the day to day supervisors but they are outside managers who have just a single role which is to rate all the employees in specific jobs.

Apart from this, the mid-level managers at Computer Sciences Corporation who have never interacted with the employees of the company had to forcefully downgrade the performance ratings of their employees in order to meet the required 40% quota level (Anna, 2013). This is highly unethical practice and these are the mistakes which resulted in the above fraudulent schemes.

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Steps which could have been taken

Some of the steps which could have been taken to avoid such unethical practice are:

The day to day supervisors should have been tasked with appraising the employees.
Managers need to interact and know their employees and learn about their traits. There are certain traits which can indicate a manipulative behavior.
Supervisors need to listen and observe the employees to identify the risks of the potential fraud.
All the people working within the organization should be clearly made aware of the fraud, its different types and the reporting system.
The internal control should be made stronger by the leaders of the company. Examples of such internal controls which could have avoided the unethical practice to occur at Computer Sciences Corporation are segregation of the duties, supervision and documentation. The documentation seems to be weak at Computer Sciences Corporation.
Finally, a positive corporate culture needs to be created at Computer Sciences Corporation where the employees should be satisfied and work in a positive work environment to prevent theft and fraud.

Role of Market Pressures on Unethical Practice

There are many arguments that the role of the market pressures and the competition in the market can cause the firms to engage in unethical practice. This is because unethical practice can lower the costs of the firm. For example, when companies make use of child labor then they can hire such labor at cheap rates and lower its costs but this is highly unethical and even illegal in many countries.

Competition could only raise the ethical standards in a long run however, companies engage in unethical behavior to make their firm more competitive in the short run (Miller, 2015). Therefore, when competition starts to increase in the market based on any factor such as market share, stock prices, cost structures etc, then firms indulge in unethical behavior to remain competitive in the market.

Influence of Finance

Finance also plays an important role in pressurizing the firms to conduct unethical behavior. When companies compete with one another then they compare their performance on the basis of their profitability, shareholder wealth, stock prices, and growth in EPS etc. However, when the financial performance of firms is deteriorating due to any external factor, then indulge in unethical and fraudulent practices such as creative accounting. The case of Computer Sciences Corporation for devising its three fraud schemes is also an example of creative accounting. For example, when the company had falsified all the diagnosis codes which had been submitted systematically to Medicaid is a true example of creative accounting.

Influence of Sarbanes Oxley Act of 2002

The Sarbanes Oxley Act had been enacted in 2002 after a series of the corporate scandals and financial abuses to make the corporate governance systems strong and enhance the compliance and ethics programs. The major influence of this act has been in the role of the leadership in an organization to avoid fraudulent and unethical behaviors. This act had defined the responsibilities for CFO and the CEOs and also enhanced the engagement and professionalism of the audit committees.

This act had guided the best law to guide he best practices within the board room. It has also enhanced the focus of the regulators and state courts and most importantly increased the consciousness of the public in raising the standard of corporate governance in firms.

Recommended Changes for Companies

Some of the recommendations for the companies to avoid financial statement fraud and present the financial statements to the public are as follows:

Internal controls need to be made strong to detect any action or unusual behavior by those who prepare the financial statements of the company.
All the main accounting functions should be segregated and measures should be taken to reduce the incentives for the fraud.
A strong control environment should be created which should be controlled by the top management to ensure best corporate governance practices.
Finally, management should also conduct the examination of its financial statements by an outside consultant. This will help the company to avoid behaving aggressively for committing unethical practices.

Conclusion

Overall, the Sarbanes Oxley Act 2002 is the best guide for Computer Sciences Corporation in order to avoid the unethical treatment of its employees and prevent the fraudulent activities which have taken place in the past. Sarbanes Oxley Act 2002 has reshaped the corporate America today. Computer Sciences Corporation needs to pay close attention on its internal controls, segregation of the duties, supervising its employees, appraising the employees through their day to day supervisors and promoting the best practices of corporate governance.

The main issue currently faced by Computer Sciences Corporation is that the company is the unethical treatment of its employees. Human Resource Management is the key aspect of any organization and all the employees should be given more independence and freedom in decision making. Finally, whistle blowing should be encouraged within the organization as this would overcome the problem of fraud. Whenever there would be any sort of unusual activity or unethical behavior, the employees would have a route to report that and save the company from severe allegations.

References

Anna. (2013, Dec 12). Allegations of unethical and illegal behavior by CSC. Retrieved July 13, 2016, from Cassandra: http://www.corporatecrimereporter.com/news/200/computer-sciences-corporation-charged-medicaid-fraud/

Miller, R. (2015). DOES ECONOMIC COMPETITION DESTROY ETHICAL BEHAVIOR? Retrieved July 13, 2016, from Firstthings: http://www.firstthings.com/blogs/firstthoughts/2011/07/does-economic-competition-destroy-ethical-behavior

Office, U. A. (2014, October 27). Manhattan U.S. Attorney Files Healthcare Fraud Lawsuit Against Computer Sciences Corp. And The City Of New York For Orchestrating A Multimillion-Dollar Medicaid Billing Fraud Scheme. Retrieved July 13, 2016, from Justice.gov: https://www.justice.gov/usao-sdny/pr/manhattan-us-attorney-files-healthcare-fraud-lawsuit-against-computer-sciences-corp-and

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Health Promotion to Pregnant Women

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Health Promotion to Pregnant Women

Introduction

All expectant women should ensure that they stay healthy during pregnancy since most of what they consume is shared with the foetus. Some of the things women take are good for the baby while others can be harmful. To educate a group of first-time teenage mothers, I will use posters to inform them about the following important information.

First, I will emphasize on the need for pregnant women to maintain a balanced diet. Most meals should include starch –based foods such as cereals, rice, fruits as well as vegetables. Women should also eat a lot of fiber and proteins. Weight monitoring is also of great importance although it has been found out that a weight increase of between 11 to 16kg during pregnancy is normal.

Pregnant women also need an extra 200 calories especially in their last month of pregnancy. Rauh et al. (2013) support the idea that folic acid supplements are ideal during pregnancy and should be taken up to the end of the 12th week of pregnancy since they aid in avoiding anemia, a common condition among pregnant women.

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Tobacco smoke contains harmful chemicals that pass through our bloodstream and goes into the growing foetus’ blood. Therefore, the pregnant woman should be counseled to stop smoking and avoid risks such as ectopic pregnancy, miscarriage, and premature labor (Piano & Phillips, 2013).

Additionally, during pregnancy women should avoid drinking alcohol because it slows down growth and causes serious problems in future. Pregnant women should also avoid pets which at times may carry germs that can be passed to the unborn baby. For instance, toxoplasma is bacteria commonly found in cats, therefore, I will educate women to wash their hands after handling cats.

This will aid in minimizing the effects of these germs. Using any illicit drugs when pregnant can have a detrimental effect on the unborn baby. Illicit drugs in most cases cause birth defects or miscarriage. Drug use can also affect the baby central nervous system according to Simkin et al. (2016).

Conclusion

Pregnant women should seek advice to get more information on how to stay healthy during pregnancy and after giving birth. Lifestyle adjustments will enable both the mother and the baby to stay healthy.

References

Piano, M. R., & Phillips, S. A. (2013). 20 Things You Didn’t Know About Alcohol. Journal of Cardiovascular Nursing, 28(4), 318-319.

Rauh, K., Gabriel, E., Kerschbaum, E., Schuster, T., von Kries, R., Amann-Gassner, U., & Hauner, H. (2013). Safety and efficacy of a lifestyle intervention for pregnant women to prevent excessive maternal weight gain: a cluster-randomized controlled trial. BMC pregnancy and childbirth, 13(1), 1.

Simkin, P., Whalley, J., Keppler, A., Durham, J., & Bolding, A. (2016). Pregnancy, childbirth and the newborn: The complete guide. Simon and Schuster.

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Assisted Reproduction Technology

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Assisted Reproduction Technology

History of Assisted Reproduction Technology

In July 1983, the first successful human-human transfer of an embryo resulting in pregnancy was announced. Biggers and John report that the procedure took place at the Harbor-UCLA Medical Center under the supervision of Dr. John Buster. Subsequently, the first birth was reported in February 1984. It is estimated that between then and now, about 350,000-50,000 babies have been born following this procedure (Biggers and John 123).

The embryo was transferred from the woman in whom it was developing to another woman to the woman who gave birth 38 weeks after. Henceforth, this was considered milestone breakthrough for women who were infertile (Biggers and John 121). It has given light to embryo donation and the use of human oocyte as an alternative to adoption for these women.

The Uses and Benefits

According to Wagner, embryo transfer or assisted reproduction technology is used for women with infertility challenges such as, blocked and damaged oviducts or those whose fallopian tubes have been removed. Women with ovulation disorders can also take advantage of this technology. As well, it can also be utilized in case of men with male factor infertility (low sperm count or sperm immobility) and persons with genetic disorders (Wagner, Marsden, and Patricia 1028).

Same gender couples and individuals who choose to be single can also use this technology. The benefits that come with freezing of embryos include the ability to store them in case you are at risk of injury or death.it is important for persons who conditions that require medical attention, which affects their fertility (Wagner, Marsden, and Patricia 1028). Freezing of embryos is also beneficial people undergoing sex-change operations. Finally, it gives people a chance to become donors and assist individuals with infertility problems.

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Problems and Risks

The only known problem with embryo transfer surface when a donor who is not registered participates without the consent of Human Fertilization and Embryology Authority (HFEA) clinic. This compromises your health and that of the child because of lack of stringent screening and testing procedures (Wagner, Marsden, and Patricia 1030). Also, it becomes unclear on who is the legal parent of the child as this can allow the donor to take the legality. Furthermore, it will be impossible for this child to have any information of the donor since it will be missing in the HFEA files.

Apart from this, there are also several risks surrounding this technology (Wagner, Marsden, and Patricia 1028). As with other medical processes, fertility medications have side effects, which range from headaches, ovarian hyperstimulation syndrome breath shortness, and fainting. Additional risks include; bleeding and infections during egg retrieval, the chance of multiple pregnancies and associated psychological and emotional stress (Wagner, Marsden, and Patricia 1028).

Society Viewpoints

There are some social aspects outlined by (Schoolcraft et al. 863). Some people, especially in professional settings, are of the opinion that this technology should be left to same gender couples only. In Asian countries, it is only allowed for married couples only (Schoolcraft et al. 866). It widely practiced in European countries while it is prohibited in South America because of religious reasons (Schoolcraft et al. 867). This is because Christians consider this technology immoral. Other people argue that the stress and pain that come with this procedure can make difficult for the parent to bond with the child.

Personal Effect

This technology has no significant effect on me because from my perception people should be given a chance to choose the mode of reproduction they consider most favorable. It is therefore not under my jurisdiction to judge it as wrong or right (Schoolcraft et al. 864). It is, therefore, a matter of individual choice because it only involves the individuals who choose it.

Works Cited

Biggers, John D. “IVF and embryo transfer: historical origin and development.” Reproductive biomedicine online 25.2 (2012): 118-127. Web. https://www.google.com/search?q=%22IVF+and+embryo+transfer%3A+historical+origin+and+development.%22+&ie=utf-8&oe=utf-8&client=firefox-b

Schoolcraft, William B., Eric S. Surrey, and David K. Gardner. “Embryo transfer: techniques and variables affecting success.” Fertility and sterility 76.5 (2001): 863-870. Web https://www.google.com/search?q=%22Embryo+transfer%3A+techniques+and+variables+affecting+success.%22+&ie=utf-8&oe=utf-8&client=firefox-b

Wagner, Marsden G, and Patricia A St Clair. “Are in-vitro fertilization and embryo transfer of Benefit to all?” The Lancet 334.8670 (2014): 1027-1030. Web. http://www.ncbi.nlm.nih.gov/pubmed/2572751

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Social Media and Networking Sites

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Social Media and Networking Sites

Introduction

Social media has been at the forefront of the digital revolution. Social media has created a borderless world and revolutionized communication by helping individuals to share information, photos, videos and other content instantly over the internet.

Background Information

Advancement in technology has led to increased access to the internet and internet-enabled devices such as smartphones and computers. This can be described as the cornerstone of social media, which relies solely on the internet and internet-enabled devices.

Since the advent of social media site, Six Degrees in 1997, numerous social media sites including Facebook, Flickr, YouTube, Twitter, LinkedIn, Pinterest, Instagram, Snapchat, MySpace, Periscope and Meerkat have been developed.

These networks have allowed users to share photos, videos, personal updates and other content online from anywhere across the globe. In this regard, social media has contributed immensely in enhancing seamless communication across the world.

Thesis Statement

Twitter, Facebook, LinkedIn and YouTube as the main social networks have each designed their networks with unique characteristics aimed at enhancing social connections while providing the best user experience.

Discussion

Twitter, Facebook, LinkedIn and YouTube continue to grow immeasurably, as individuals seek convenient avenues to communicate and share information. While most social media networks serve closely related purposes, each has its own unique characteristics. These are discussed below:

Twitter

Twitter’s main purpose is to help individuals connect with what is of interest to them, whether it is friends, celebrities, experts or news agencies.
The post length on Twitter is only 140 characters. This means that the networking site is more concerned about creating interest than providing detailed information.
A user’s connections on tweeter are known as tweeps, while statements posted by users are known as tweets.
To connect with another user and see their updates, one must ‘follow’ them by clicking the follow button.
Hashtag (#) is a prominent and widely used feature on Twitter. The # is used in creating key words used to refer to a specific subject, such that others can follow and contribute to the conversation through the hash tag. Clicking the word with the hashtag, the user can read all posts related to the subject.

Facebook

Introduction

Facebook encourages people to reconnect and find new connections online. Through the use of email, images, instant messaging and video sharing, Facebook allows users to look for family members or long lost friends through their profile.
A Facebook post may consist of a maximum of 63,206 characters, which gives users freedom to express themselves in both short updates and detailed updates to keep their connections informed.
An individual’s connections on Facebook are known as ‘friends’ and can share information, photos and videos on each other’s ‘wall’, which is the individual profile page where account owners can share thoughts, pictures, videos and other content.
To connect with a friend, one is required to make a friend request on the page. The potential friend then receives a notification and decides whether to accept or decline the request

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LinkedIn

LinkedIn users link and follow each other through connections.
Users provide personal information including education qualifications, professional qualifications, work experience, current employment details and contact details to allow interested persons to ‘connect’ with them.
LinkedIn allows users to connect to others through people already known to them. Using the ‘Get introduced’ function, users can send messages to current contacts to introduce them to a potential contact.
LinkedIn helps users to obtain information that is highly relevant to them by suggesting groups with relevant information. The ‘Groups You May Like’ makes an analysis of attributes that are similar between members through algorithms and then suggests the groups to members depending on their interests.

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YouTube

YouTube allows video sharing through users’ YouTube accounts, also known as ‘channels’. These may range from short videos to videos that are 11 hours long and a maximum of 128GB.
Advertisement revenue is a prominent feature of YouTube, with advertisements being strategically placed in the most popular videos. By creating interesting or popular video content, users can earn money based on the number of advertisements linked to their content.
YouTube has a ‘Trending’ page, which allows users to find popular and current content as quickly as possible
The popularity of videos is determined by the number of views.
Users often rely on the views and video shares to determine how well their videos were received.

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Conclusion

This discussion is a clear indication of how social media has enhanced interaction between individuals and also enhanced the flow of information.
It is apparent that social media has indeed been instrumental in enabling social and professional connections in the contemporary society.
A discussion of the most popular social media networks being Twitter, Facebook, LinkedIn and YouTube reveals that each social media network is created with a specific objective, and that the various characteristics possessed by these media have enhanced their use and relevance to users.
As technology continues to advance however, it is imperative for social media sites to diversify and allow users to share additional content in order to garner additional users.
As an example, it is notable that technology advancement and availability of high speed internet has enabled live video streaming over social networks. This is a feature that the social media networks discussed above can utilize to enhance connections and attract users.
Social media networks should not be rigid in terms of the content that should be shared by users and they should therefore strive to provide variety and innovation in sharing content.

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