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Theoretical basis of Finance
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Critically assess and evaluate the theoretical basis of finance.
Critically analyse, interpret financial data, by the integration of theory and practice investigate and apply relevant tools to the assessment of a variety of organisational problems.
Systematically evaluate and synthesise the problem solving mechanisms in relation to financial decision making, utilising application of relevant tools and techniques.
Assessment Task: Using the FAME database, choose a publicly quoted company of your choice.
Write a business report of 2,400 words on the company from the stance of a potential investor. Your review of the company should discuss which key areas you are considering and why. The use of ratios should be accompanied with the limitations associated with their use and what additional data would be required for a full financial review. Your review should incorporate a commentary as to how well the company is performing within its industry sector and/or against a main competitor.
Theoretical basis of Finance
Consider why there may be differences. Looking to the future, discuss what main risks and opportunities the company is facing and how they are addressing these. This section of your report could include both a financial and a non-financial analysis. Appendices may be used to contain information to support your report. It would not be expected that a full set of accounts should be included in the appendices, but extracts from the accounts may be appropriate. One of the appendices should contain your bibliography. The appendices are not included in the word count.
Write a business report, maximum number of words 2,400, to evaluate a public limited company (PLC) of your choice. Your report should detail the areas that you would consider necessary to review and why, including limitations of the analysis. The report should finish with conclusions and recommendations for the investor.
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Theoretical basis of Finance
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Theoretical basis of Finance
Jaguar Land Rover Automotive PLC is a holding company for the automotive company by the same name. The company, headquartered in Coventry, UK is a subsidiary company to Tata Motors. This paper focuses on the financial analysis for Jaguar Land Rover PLC by looking into the various metrics of financial performance. These metrics used in this analysis include the measures of profitability such as the net profit margin, the return to shareholders’ fund, and the return on capital employed. Other metrics used are the analysis of the company’s liquidity and gearing.
Profitability
Net profit margin
Net profit margin is the ratio that analyses the company percentage of revenue left after all the expenses have been deducted. It shows the company profit earned from the sales it has made. Net profit margin is calculated as: net profit divided by sales multiply by one hundred. Higher net profit margin is an indicator that the company has a good pricing strategy and control any cost incurred effectively. “Jaguar Land Rover Automotive PLC” can use this ratio to compare its performance with other companies in the same industries since firms in the same industry experience almost same environmental change, has got similar cost structure and common customer base (Kraft, 2014).
The net profit margin of a company that is higher than 10% is considered to be better, however, the rage of best net profit margin depends on the industry that the company operates in. in the case of “Jaguar Land Rover Automotive PLC,” it will be good if the company would have been having 10% or more. In general conclusion, the higher the profit margin, and the more profitable the firm is and this margin is affected by the operating expenses (Brigham & Ehrhardt, 2013).
In the years 2009 and 2010, the company made losses and therefore was not having a net profit margin. This implies that the company expenses in the years 2009 and 2010 are proportionately higher than the years after, it also indicates poor pricing and model and ineffective control of business costs. In the years 2011, 2012, 2013, 2014 and 2015 the company profit margin shoots to over ten percent that is, 11.30%, 11.15%, 10.61%, 12.90% and 11.95% respectively. This indicates a perfect improvement by the company as compared to the previous years.
In these three years, the management of the company seems to have formulated good pricing strategies and exercised effective cost control. This, in turn, has caused the company profit to increase by larger amount hence increased profit margin (Fitó et al., 2013). The company expenses during these five years are observed to be proportionately lower than in the years 2009 and 2010. The company profit margin has decreased by a relatively bigger margin in 2016 and 2017; profit margin has dropped to 7.01% in 2016 then further to 6.27% in 2017 provided the company turnover is higher in those years. Company’s costs have increased in these two years as compared to…….
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Leinenger’s cultural theory
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Write a one to two-page summary on key assumptions of Leininger’s Culture Care theory and summarize the implications of this theory for your chosen advanced nursing role.
Leininger’s Culture Care Theory attempts to provide culturally congruent nursing care through “cognitively based assistive, supportive, facilitative, or enabling acts or decisions that are mostly tailor-made to fit with individual, group’s, or institution’s cultural values, beliefs, and lifeways.” The intent of the care is to fit with or have beneficial meaning and health outcomes for people of different or similar culture backgrounds
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Euthanasia
Incorporating a Theory
Management of terminally ill patients is pretty demanding. Clinicians taking care of these patients are always passed with several questions. How can I be most helpful to this patient? What is the most appropriate manner of delivering news of a terminal diagnosis? However, the most important of all these questions that they ask themselves is how they can develop a thoughtful and reasonable plan for end of life care? It is for this reason that I chose the Lewis’s theory of change as the most crucial theory of euthanasia.
Despite proposing that euthanasia is the best approach for patients nearing their end of life, I strongly believe that health officials should equip themselves with necessary skills for managing these patients before they may request for euthanasia.
In today’s world, hospital settings are receiving a high number of patients who are put under palliative care. Most of these patients tend to engage in poly-pharmacy where they are prescribed more than four drugs. The probability of medical errors to occur in such hospital settings is high. Such errors usually lead to disturbing consequences not only on the patient but also on the nurse.
The occurrence of such errors can however be minimized significantly through the incorporation of technology that promotes patient care and saves time for the busy nurses. An example of an approach that can be used is the Bar-Coded Medication Administration (BCMA). This technology entails the use of scanning devices to contrast bar codes installed in patients with codes that display the prescribed drugs, electronically identifying the possible errors against the medical records, hence decreasing the occurrence of medication errors drastically.
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However, implementation of change in practice is usually associated with production of anxiety or fear of failure in nurses resulting in resistance to this change process. It is for this reason that Kurt Lewis’s theory of change comes in handy. Most healthcare institutions have used this model to study human behavior and how it is related to change as well as the patterns of resistance to the change.
The model determines forces that inhibit change implementation and factors that drive the change process. By identifying these two forces, health care organizations can then work towards strengthening the positive driving forces and find solutions to the impeding forces.
Kurt Lewis Theory Incorporation
This theory is made up of three stages; unfreezing phase, moving phase, and the refreezing phase.
Unfreezing phase
During this stage, round table discussions can be conducted with the aim of teasing out the supporting and impeding forces. This will be essential particularly in identifying the challenges that should be overcome. Some restraining forces in this facility may include; lack of computer experience, staff resistance against the use of computerized devices, dislike of the new system, and the cases of workarounds. BCMA is implemented successfully without instances of dangerous workarounds with maximum investment in the results.
On the other hand, the driving forces may include; enough financial investment, proper time management, support from top level managers, and potential ease of use.
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Moving Phase
This phase involves the actual change including planning and implementation of the project. Bar code implementation may require corporation from various teams such as the clinical information services, information technology (IT), pharmacy, clinical nurse educators, program managers, and administrators. A project leader should also be chosen to oversee and assess all phases of this project. Some of the challenges that can be encountered during this stage include the rediscovery of workarounds. However, they can be solved through provision of further education.
Refreeze Phase
This is the final stage. Here the there should be ongoing support of the clinicians on the frontline. All stakeholders should also be accorded technological support to a point where the change is deemed complete and all users have familiarized themselves with the technology and are comfortable with it. Once the process is fully functional, an analysis and summary of the challenges encountered, successes met, and problems encountered should be done for future reference. Any project of this magnitude can realize massive success once the Kurt Lewis theory of change is implemented.
Review of Literature
Euthanasia is a clinical practice that is carried out usually in terminally ill patients such as cancer patients who are suffering severe pain. Thienpont enlightens that, it can be conducted either through administration of a lethal injection or blocking a patient’s feeding tube (Thienpont et al, 2015). However, this subject of euthanasia has raised heated debates on whether it should be conducted or not. Math and Chaturvedi conducted a research to seek views on whether it should be executed or not.
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From their study, they learned that some proponents of euthanasia argued that terminally ill patients occupy valuable space in hospital beds. They also argued that the long term palliative care accorded to the patients is a huge waste on medical resources. However, others opposed these views saying that it is not fair to kill someone just on petty grounds that hospital beds are needed by others.
Terminally ill patients can be provided other avenues such as special hospices or homes where they can be taken care of. They even went further and stressed that if caring for the terminally ill is a waste then it would be just for the medical practitioners to deny medication to the elderly who are nearing the end of their life as well. To them, the description of hospice care as a waste of medical resources was rather harsh and families of terminally ill patients cannot agree to this statement.
According to Bauman and Dang, the best approach of managing patients with chronic diseases such as cancer or dementia is through hospice and palliative care (Bauman and Dang, 2012). Hospice care involves cooperation among several health officials from nurses, mental health professionals, clergy men, and to social workers all of whom act towards achieving a common goal, that is, providing the needs of chronically ill patients. Furthermore, they help in assisting family members who are constantly involved in the patient care process.
These officials work around the clock including weekends and holidays to offer their patients with a 24/7 care and assistance which they require desperately. According to Shah and Mushtaq, these specialists listen to and address the complaints of not only the patients but also the patient families (Shah and Mushtaq, 2014). They also provide counseling services and use advanced medical procedures and technology.
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According to Compas, et al, majority of these hospice and palliative care specialists help patients in patients’ homes so that these patients can spend the remaining time of their life with their loved ones and friends (Compas, et al, 2010). They can also assist patients at nursing homes, hospitals, and assisted living centers. These specialists are typically registered nurses (RNs) most of which hold a bachelor’s or a master’s of science degree in nursing. Their training involves
Carrying for terminally ill patients is accompanied with emotional circumstances that physicians usually find difficult to respond to (Leiva, 2010). Clinicians should therefore before be assisted from all specialties in attending their patients. Research has proven that even the most thoughtful health officials struggle with issues that arise when managing dying patients. This does not necessarily refer to assisted suicide of the patients under palliative care but rather to the overall emotional climate that encompasses this process whereby all that can be done medically has been done.
The most important attribute for such clinicians is being a straight shooter. Usually, patients and their families request that clinicians should be straight shooter. This actually means that they should use the truth when the patients and the families require it most. This may not cure or bring any form of happiness. However, being honest signifies that the clinician can be counted on to describe exactly the difficult times to be faced and offer solutions to these challenges.
Omipidam emphasized that it is important for physicians to understand that ethnicity and culture play a crucial role in management of patients in some communities (Omipidam, 2013). Therefore, physicians are advised to enquire from patients if they would like to receive information and make decisions or if the family wants to take care of the issues.
Moreover, physicians should maintain routine hospital calls. Just as it is crucial not to desert a patient to a consultant, it is equally important to ensure that regular visits to the terminally ill patients are maintained. The family as well as the patient should be well informed acutely of the frequency and the duration of the visits. The research conducted by Boudreau proved that physicians have a tendency of changing their schedules and shorten visits once the patients enter the last stages of illness (Boudreau, 2011).
One does not need to be a practitioner to correctly understand what this distance behavior has on the family and the patient. Maintaining frequency and duration of the visits will increase the understanding of the family, patient, and the physician.
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Most terminally ill patients suffer from depression (Katon, 2011). As a result, physicians should be well skilled in managing such psychological issues. Stuck and Nobel implied in their study that engagement of creative arts such as music engagement, expressive writing, and visual arts can be used to improve health outcomes (Stuckey and Nobel, 2010). This is because they help in enhancing an individual’s emotions, moods, and other psychological states.
Some of the countries that have legalized the proposed change- euthanasia include Netherlands and Belgium. Pereira ascertains that one of the main reasons for undertaking this policy was to relieve pain and suffering among terminally ill patients. However, Ncayiyana opposes this practice citing reasons that it does not show dignity and respect to human life (Ncayiyana, 2012).
The author offers alternative solutions saying that improvements on medication have been done to promote patients quality of life and ensure that their deaths are as humane as possible. The scholar argues that a person in sedation state still is still biologically alive and has the right to live until his/her natural death.
In some cases, patients request for euthanasia. However, Schüklenk, confirms that several organizations such as the European Court for Human Rights have since ruled that no one has a recognized right to die whether with the aid of a third person or a public authority (Schüklenk, et al, 2011). He debates that if people were given the right to take their life, then people that are critically injured or the very old would have been compelled to request their death.
Hickman and Douglas oppose the idea that relatives can call for euthanasia to spare themselves the miseries of watching their loved ones go through agony and severe pain (Hickman and Douglas, 2010). Nevertheless, they have no right whatsoever to end life of the patients despite them being relatives.
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A survey conducted by Bennett et al on 200 doctors and 400 nurses, indicated that almost 94% of the nurses and 95% of the doctors viewed hospice care to be very important for patients with life-threatening conditions. Almost all these doctors and nurses wanted hospice care to be made readily accessible. They also agreed that the general public should have more information regarding hospice palliative care and end-of-life care training should be fundamental in medical and nursing education (Bennett et al, 2010).
However, the surprising fact from this survey was that 72% of the doctors and 28% of the nurses revealed that medical professionals do not enough concerning palliative care. This indicated the existing gap of knowledge that is used in support terminally ill patients. According to Bennett et al, basic medical education is not sufficient for hospice care training.
The environment, values, and culture in clinical settings and other places of care should encourage and promote greater openness and discussions about end of life. Policy makers in the field of healthcare should also seek ways of supporting and creating more opportunities and avenues for nurses to employ in their practice of hospice care in whichever specialty they are in.
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Bennett, H. D., Coleman, E. A., Parry, C., Bodenheimer, T., & Chen, E. H. (2010). Health coaching for patients with chronic illnesses. Fam Pract Manag, 17(5), 24-29.
Boudreau, J. D. (2011). Physician-assisted suicide and euthanasia: Can you even imagine teaching medical students how to end their patients’ lives? The Permanente Journal, 15(4), 79–84.
Compas, B. E., Jaser, S. S., Dunn, M. J., & Rodriguez, E. M. (2012). Coping with chronic illness in childhood and adolescence. Annual Review of Clinical Psychology, 8, 455–480.
J. Katon, W. (2011). Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues in Clinical Neuroscience, 13(1), 7–23.
Leiva, R. A. (2010). Death, suffering, and euthanasia. Canadian Family Physician, 56(6), 528–530.
Math, S. B., & Chaturvedi, S. K. (2012). Euthanasia: Right to life vs right to die. The Indian Journal of Medical Research, 136(6), 899–902.
Ncayiyana, D. (2012). Euthanasia: No dignity in death in absence of an ethos of respect for human life. The South African Medical Journal, 102(6), n.p.
Omipidam, B. A. (2013). Palliative care: An alternative to euthanasia. BMJ Supportive and Palliative Care, 3(2), 229.
Pereira, J. (2011). Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls. Current Oncology, 18(2), 38–45.
Schüklenk, U., Delden, J. J. M., Downie, J., Mclean, S. A. M., Upshur, R., & Weinstock, D. (2011). End-of-life decision-making in Canada: The report by the Royal Society of Canada Expert Panel on end-of-life decision-making. Bioethics, 25(1), 1–4.
Shah, A., & Mushtaq, A. (2014). The right to live or die? A perspective on voluntary euthanasia. Pakistan Journal of Medical Sciences, 30(5), 1159–1160.
Stuckey, H. L., & Nobel, J. (2010). The connection between art, healing, and public health: A review of current literature. American Journal of Public Health, 100(2), 254–263.
Thienpont, L. Verhofstadt, N., Loon, T., Distelmans, W., Audenaert, K., & Deyn, P. (2015). Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: A retrospective, descriptive study. BMJ Open, 5(7), n.p.
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Theory X and Theory Y of Management
Introduction
According to this theory, the managers view employees in different human nature concepts which he labels as Theory X and Theory Y. This theory demands the managers to reflect about their employees including issues such as how do you treat the employees? How does the manager talk to them? This is important to know because it enables the management learn where they are in the Theory X-Theory Y continuum.
In Theory X, managers assume that employees generally heat work and that the average employee is lazy, lacks ambitions and is generally lazy. This theory assumes that employee motivation is money. This type of manager is sharp contrast to Theory Y. Theory Y managers assume that employees and highly satisfied by their work and exhibit high level of creativity. According to this theory, employees seek recognition and self-fulfilment than money (Korzynski, 2013).
How I Identify and Differ With This Style
I identify with this management theory because I believe that it is very important to understand the various ways to treat human nature, as most of the employee behaviour observed in their work place is a reaction to management style. For instance, the management that believes employees avoids responsibility and must be coerced to achieve organizational goals are likely to set strict measures to the employees dictating what they want the employees to do, ways they want it done and closely monitor them.
This communicates lack of trust to the employees In this regards, the employees reaction towards work is negative, which convinces the managers that their assumptions is actually correct. On the other hand, Theory Y managers have entirely different assumptions. In this type of management, they make their decisions by consensus. This enhances the employee’s sense of belonging. By empowering the employee, the employee’s authority increases and tends to be responsible. This management encourages the employee creativity as well as teamwork and are more likely to reward them. As a result, the employee’s reaction is positive because they are treated with respect and support (Mikkelsen, Jacobsen, & Andersen, 2015).
Despite the fact that the theory explanations of management and employees performance are feasible- I highly doubt that there are managers who are purely X or Y. The theories are designed to help the management understand their natural instincts and help them appreciate their attitudes such that they can adjust to certain situations within specific environment and organizational culture.
In this regards, it’s not a question if one is a Theory X or Theory manager. Irrespective of the type of management, the work must be done. Therefore, the key to success is evaluating your organization to identify the styles that are more consistent with bringing out the highest motivation levels and improve employee’s productivity (Reed & Bogardus, 2012).
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An Example of Business That Has Applied Theory Management Style
An example of business that has applied Theory Management style in their organization is Google Company. The Google Company gives their students much freedom to ensure that they enjoy working at this company. The management looks at the employees tend to believe that they are self-actualizing as well as self-fulfilling. In Google Company, there is no micromanagement of the employees because they want them to be creative and improve their sense of belonging by making them take ownership of their work.
This company does not motivate the employees with fear of getting fired if they do not deliver quality work, but rather it encourages and empower employees to ensure that they take initiative to pursue their life goals. When the employee’s psychological needs are improved, they become motivated and are ultimately more likely to accomplish their company’s goals. The organizations push their workers to ensure that they understand their self-actualisation alongside the company’s goals set. The employees are given flexibility and ensure that the work place is comfortable. This motivates the employees to remain productive (Korzynski, 2013).
Case study
During the unstable economic times, many companies management are expected to make tough decisions regarding the organization work force structure and size. The director of Tri-County Home Health Agency is expected to implement a reduction in force (RIF) program also commonly known as lay-off. This requires a lot of interaction with the top management officials and human resource manager to evaluate the jobs that need to be eliminated and ways the employees needs to be notified about the decisions. In this case, Theory X will work effectively (Gandolfi, & Hansson, 2010).
Before implementing RIF, the management should explore all the alternatives available. This is because RIF could be a quick answer, but may not make sense in the long-term. Other alternatives such as reducing work schedules, salary reduction, freeze of hiring, reduction of employee’s contribution and natural attrition. After reviewing these options and RIF still remains the best step for the company it is important for the management to explore ways to go about it.
The following should be put into consideration, including what departments or divisions are likely to be affected or will RIF affect the entire organization. In this case, what employees are essential to keep the company running, what set of skills are very vital in the organization for future (McConnell, 2010).
One of the challenges during this process is selection of employees who will undergo lay-offs. This is complex due to the impact of disparate analysis. In this regards, the selection criteria should be based on employee’s level of experience, versatility and proficiency. The unnecessary jobs categories and classifications should be eliminated. The employee’s performance can be evaluated using data from job appraisal. To decide on whom to let go or stay, the management should strive an objective comparison of its employees. Strict compliance with the requirements must be maintained, failure to which employee’s claim of discrimination can be enforced (Gandolfi, & Hansson, 2010).
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Conclusion
To communicate to the employees, a note of warning must be given to organizations. This facilitates quick action which is important for people who are staying and those who are leaving. All information about severance should be clear to ensure that every person understands it. The management should predict the questions anticipated and address the issue from the start.
Additionally it is important to the employees sign a release to avoid the employees taking action against the organization. It is also important to communicate with the survivors as they are equally affected. Additionally, the survivors are expected to match the same output level or even higher, which calls for motivation, giving the employees sense of hope and belief (McConnell, 2010).
References
Gandolfi, F., & Hansson, M. (2010). Reduction-in-force (RIF) – New developments and a brief historical analysis of a business strategy. Journal of Management & Organization, 16(5), 727-743. http://dx.doi.org/10.5172/jmo.2010.16.5.727
McConnell, C. (2010). Umiker’s management skills for the new health care supervisor. Sudbury, Mass.: Jones and Bartlett Publishers.
Mikkelsen, M., Jacobsen, C., & Andersen, L. (2015). Managing Employee Motivation: Exploring the Connections Between Managers’ Enforcement Actions, Employee Perceptions, and Employee Intrinsic Motivation. International Public Management Journal, 1-23. http://dx.doi.org/10.1080/10967494.2015.1043166
Reed, S., & Bogardus, A. (2012). PHR. Hoboken: John Wiley & Sons
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Beck’s Cognitive Theory of Depression: Incorporating Theory
Description
For the proposed research, the PICO question that guides the study is as follows: In young adults aged 30 to 35 years-old (P), is using a screening tool for depression (I), in comparison to the usual standard of care (C), more accurate in detecting depression (O). This PICO question helps in finding out whether or not there is sufficient evidence to support screening young adults aged 30 years to 35 years for depression with the use of a suitable screening tool.
Utilization in Supporting Solution
The theory that could be utilized in supporting the proposed solution is Beck’s Cognitive Theory of Depression. Beck identified 3 main components or mechanisms which are responsible for depression. These include: (i) negative self schemas; (ii) the cognitive triad; and (iii) errors in logic, that is, faulty processing of information (Abela & D’Allesandro, 2012). The cognitive triad are 3 types of negative thinking which are common in people who have depression: that is negative thoughts concerning the future, the world, and the self.
These negative thoughts are automatic in individuals with depression since they occur impulsively. Beck pointed out that people who are prone to depression develop a negative self-schema. Such an individual possesses various expectations and beliefs regarding himself or herself which are pessimistic and negative. Individuals who have negative self schemas are inclined to making logical errors in their thinking. They are also inclined to focusing mainly on particular facets of a situation whilst disregarding other information that is equally pertinent (Abela & D’Allesandro, 2012).
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The rationale for selecting this theory is that this theory helps to describe what really is central to depression; that is, the main cause of depression. According to Beck, the cognitive symptoms of depression in fact precede the mood and affective symptoms of depression, and not the other way round. What is central to depression, as Beck pointed out, are the negative thoughts and not low reinforcement rates or hormonal changes as other theorists had suggested (Abela & D’Allesandro, 2012).
This theory works to support the proposed solution in that using depression screening tools, the researcher will be able to determine more accurately the main cause of depression amongst young adults in the United States. In other words, using appropriate screening tools for depression, it would be possible to detect the negative thoughts in people aged 30-35 in the United States considering that negative thoughts are central to depression as per Beck’s Cognitive Theory of Depression.
Incorporation
The theory would be incorporated into the project by using screening tools for depression which are in line with Beck’s Cognitive Theory of Depression. One particular screening tool that would be used is the Beck Depression Inventory-II (BDI-II) which was developed by the same theorist who conceptualized Beck’s Cognitive Theory of Depression. The BDI-II screening tool for depression would be utilized to detect depression among 30-35 year-old young adults and it would be compared with the usual standard of care currently being practiced in the country.
In essence, using Beck’s Cognitive Theory of Depression, the negative thoughts of people would be carefully monitored using Beck Depression Inventory. It is expected that depressed people negatively misunderstand information and experiences, as they limit their focus to the negative facets of a situation, therefore feeling hopeless regarding the future (Abela & D’Allesandro, 2012). Using Beck’s Cognitive Theory of Depression in the project, a direct correlation is postulated between severity of symptoms of depression and negative thoughts.
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Application of Systems Theory
Description of System
Health care systems may be established in different settings, making it vary the elements it is composed of. A number of challenges may be experienced depending on the nature of the environment of a health care system. Home care is one kind of the systems of nursing care, where patients receive support and care from their homes or where care is delivered within a community locale.
Considering the elements forming a home based care system, it is predictable that nurses and other health practitioners are bound to experience challenges in their daily work. Among the many issues that home health care faces, communication hitches are the most common. Open system theory can be used to analyze a home based care unit so as to describe the challenges it experiences.
In this case, home-based care may be taken as a nursing production unit. Basing on the Systems theory, a number of elements should interact to form the whole. There should be inputs to feed the system while outputs are as a result of operations and transformations that inputs are subjected to. This nursing production unit is kept in motion by throughput and feedback processes.
Therefore, basing on Systems theory, home care as a unit is made complete by inputs, outputs, throughput, and feedback processes. A thorough appraisal of this components can play a big role in determining potential sources of issues affecting home-based care, and therefore, it helps in formulating necessary solutions.
Inputs
In a home care system, some of the important factors that contribute to inputs include a number of energic sources like information, resources, nurse characteristics and the features of care receivers.
Characteristics of care receivers: In a home-based care, young or old age is an important feature of those who benefit from this kind of nursing production. Basically, the aged and the young forms this group as they may experience access challenges to health facilities. Chronic health conditions are predominant in this system, where patients have developed conditions that are ever recurring.
More than 80 percent of adults, who are over sixty-five years of age suffer from at least one long-term condition, while 50 percent of the same category of adults suffer from two or more chronic diseases (Brennan-Cook, & Molloy, 2016). This indicates that caregivers have a huge workload of addressing the large number of the elderly, who develop complex conditions and other comorbidities day after day.
Old age is yet another factor that makes health conditions to persist over a long period. Language and speech of these group of persons are troublesome in most cases. As Brennan-Cook & Molloy (2016) states, older people undergo a number of natural physiological changes that interfere with their communication abilities. Old age, as a characteristic of the nursing care recipients in the home care system, is the most significant issue. Health care recipients in this system may be resilient and conservative which affects care delivery.
Characteristics of caregivers: In a home care system, nurses and other care deliverers need to have a high level of competency to meet demands. Nurses form part of the inputs of the system, feeding the system in the sense that they provide care and services needed by home care recipients. Community or home care nurses should be well experienced and conversant with chronic conditions in this setting. They also need to have high levels of expertise so that they can handle a diverse nature of complex conditions and comorbidities.
Other Inputs: There are quite a number of specialized fiscal resources that are needed to deliver care in this system. Communication technologies, support and self-medications devices can play a significant role as inputs.
Throughput
In a home care setting, this entails factors such as care delivery happening in a local and informal setting which relies a lot on a close relationship established between caregivers and recipients. This will involve the type and quality of operations and services that a health care team offers to patients. Services that can be offered to receivers of home care includes medications, counseling, and educational services.
Outputs
If effective service delivery has been achieved, home-based care can result in noticeable changes in patient outcomes. Safety of both patients and care providers is guaranteed from good interactions of the system’s elements. Improved quality of life, reduced severity of chronic infections and a lowered number of comorbidities among the elderly are some of the expected patient outcomes.
Negative Feedback
Persistence of conditions, reluctance to comply with caregivers and other poor patient outcomes are good measures of performance of the home care system. They are vital for system’s self-evaluation, which triggers positive change.
Communication Problems in Home Care
As identified earlier, communication plays a vital role in defining outcomes from a home care system. In all the elements, especially inputs, ineffective communication causes poor performance of the whole system. Healthcare receivers have a likely disability in their communication because of their physiological changes. Old age tempers with speech and hearing, which makes their relationship with caregivers demanding.
Communication challenges that recipients have require that nurses and other health practitioners have great expertise so as to compensate for the weaknesses in one element of the system for its maintenance. Despite that patient’s characteristics may hinder communication, it is the responsibilities of nurses to devise ways of enhancing effective interactions. Technical and professional nursing language may be a hindrance to a good patient-nurse relationship. Throughput and negative feedback may face interference as they rely on effective communication.
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Solutions to Communication Issues
Outcome
Improved patient outcomes of the elderly people, facing communication challenges as a result of natural physiological changes that interferes with listening and hearing.
Goals/Objectives
To ensure that all the elderly persons receiving home care achieve the best outcomes from their interactions with nurses by adequately training them so that they are equipped with better communications strategies and ability.
To better patient-nurse relationship by eliminating communication barriers through regular training of both nurses and care recipients, and through an incorporation of helpful technologies.
Policies
All nurses and students should be adequately trained, and must have a certificate showing that they can effectively communicate in a home care system before they get licensed to work in the care system.
Educative sessions and training, for both patients and nurses, should be carried out at least once a year, with the purpose of ensuring a positive patient-nurse communication relationship.
Professional Standards
Nurses should be in a position of playing a vital role in ensuring effective communication in whatever interaction they have. They should have excellent skills in processing, recording, assessing and reporting various types of information.
How Resolutions will uphold visions, values, and Mission
The recommended resolutions can help achieve the visions and the missions and values that the organization advocates. Some of the values and visions upheld by the system include resilience, discipline, honesty, advocacy, satisfaction, among others. Promoting training and education of nurses on matters of effective communication can help to achieve this. Effective communication is crucial for advocacy and in edifying the importance of the system’s value.
Given that the system has a mission of bettering the community life, effective communication policies will help in getting feedback, improving patient-nurse interactions among other practices, all of which have a potential of improving the quality of life.
References
Brennan-Cook, J., & Molloy, M. A. (2016). Utilizing Trigger Films to Enhance Communication Skills of Home Care Clinicians. Home Healthcare Now, 34(7), 376-380. Retrieved from. DOI: 10.1097/NHH.0000000000000409.
Johansson, C., D. Miller, V., & Hamrin, S. (2014). Conceptualizing communicative leadership: A framework for analyzing and developing leaders’ communication competence. Corporate Communications: An International Journal, 19(2), 147-165. Retrieved from http://www.emeraldinsight.com/doi/pdfplus/10.1108/CCIJ-02-2013-0007.
Erikson’s Psychosocial Development theory: Stages Case Study
Divorce or parents separation is associated with behavioral issues displayed by children. This is because family separation is a challenging obstacle for the whole family. Children are usually not emotionally mature to understand the situation; therefore, their stress and frustrations are often manifested by changing some aspects of their behavior. Erikson’s psychosocial development theory indicates that human undergo through a series of developmental stages. These include; Trust vs. Mistrust, Autonomy vs. shame, initiative vs. guilt, industry vs. inferiority and identity vs. confusion (Burn et al. 2013).
Explanation of John’s behavior
In this case, John developmental stage falls under identity vs. identify confusion stage of the Erikson’s psychosocial development theory. This indicates that John’s behavior is driven by feelings of frustration, confusion and anger. These negative emotions are associated with diminished school performances and achievements. The fact that he leaves school early without permission or late of school in the past 60 days indicated that he could be indulging in risky behavioral activities such as alcohol and drugs (Bowden & Greenberg, 2010).
Two priority nursing concerns and nursing interventions
The main characteristic of divorce is impaired parenting. This refers to the inability of either parent to maintain or establish an environment that promotes optimum development of John. Therefore, the two priority nursing concerns are (Paul, 2016):
Poor academic performance related to social isolation, poor family cohesiveness and lack of communication.
Intervention: The nurse should use active listening to explore the child developmental expectations and needs within the context of socio-cultural influences. This will be achieved by interviewing the child in absence of his care taker in order to make him express his frustrations freely (Burn et al. 2013).
Incidence of psychological trauma related to social isolation, changes in family unit and maladaptive coping skills.
Intervention: The parenting styles and behaviors should be examined including the child’s environment, type of interaction and presence of other behavioral problem. The nurse should institute neglect/abuse protection measures if risk of neglect and abuse is suspected (Murphy, 2012).
Reference
Bowden, V. & Greenberg, C. (2010). Children and their families. Philadelphia: Lippincott Williams & Wilkins.
Burns, Catherine, Dunn, A., Brady, M., Starr, N. B., Blosser, C. (2013). Pediatric Primary Care, 5th Edition. [VitalSource Bookshelf Online].
Murphy, M. (2012). Parental divorce: Relationship between ego strengths and impact of divorce on adult children from an Eriksonian perspective. Retrieved from http://library.argosy.edu
