The Role Of Ward Based Advanced Nurse Practitioners Nursing Essay

The Role Of Ward Based Advanced Nurse Practitioners Nursing Essay This original research was conducted in a large teaching hospital in North West England that examined ward-based Advanced Nurse Practitioners (ANPs) and aimed to clarify their roles and expectations in patient care and how they impact the clinical practice. Study participants (which consist of five ANPs, 14 ward-based nurses, and five patients) were observed and invited to participate in interviews. The roles and skills of ANPs were observed and gathered from the interviews. ANPs were described as pivotal in the management of patient care and served as an invaluable link between the medical and nursing team. They frequently translated medical information for nurses, patients and other allied healthcare professional to make sure that the plan of care was well understood and provide further explanations if necessary. ANPs were observed to be confident practitioners, good information resource and by using their technical knowledge and skills served as a role model to support the nurses and junior doctors to enable them to be more efficient in providing care. In addition, ANPs were found to be less intimidating than doctors and more approachable in resolving care issues. Meanwhile, ANPs were faced with a number of challenges and have to ove rcome skepticism from other health professionals who have different views on the ANP role expectation and scope of practice. ANPs perceived that their education had not adequately prepared them for their clinical role. ANPs have great impact in nursing practice and patient care. Although the study strives to clarify the role of the ANPs, the findings regarding the role of ANPs are not clearly defined and lack consistency that may lead to role conflict and overload. Running Head: How are acute care nurse practitioners enacting their roles in healthcare teams? A descriptive multiple-case study This multiple-case study conducted in two-university affiliated teachings hospitals in Quebec, Canada aimed to understand how cardiology acute Care nurse practitioners (ACNPs) enacted their roles in healthcare teams. Data were collected from interviews, field notes, documents and time and motion study of NP activities. The work activity pace was faster before noon due to patient care demands. Participants in one hospital believed that NP role was not an integrated role of medical and nursing components but an expanded role because they assumed more expanded nursing role components than the medical role. In addition, NPs needed to consult with physicians for patient care decision making that were within their scope of practice. They did not have that much authority in regards to decision making due to lack of structures to formalize the organizational role. There were also inconsistent messages about the role expectations to attempt to formalize the prescriptive authority of NPs which had not been approved by the medical advisory board. On the other hand, participants in the other hospital believed that NPs enacted their role more in the medical component since the medical directives and prescriptive privileges had been approved by the medical advisory board. NPs had greater autonomy in their role and prescriptive authority. It was also noted that NPs participated very little in nursing activities such as implementing nursing care plans or use of clinical care pathways. In both hospitals, the largest role component was the clinical role. The transfer of prescriptive and decision-making authority must be addressed to enable NPs to work their full scope of role to optimize patient outcomes. Clarifying role structures were expected to enable the NPs enact their role in healthcare team and prevent role confusion. Running Head: Defining NP scope of practice and associated regulations: Focus on acute care This review of literature was conducted to define the NP scope of practice (SOP) with emphasis on NPs in acute care setting. Documents were gathered from different resources including National Council of State Board of Nursing (NCSBN), individual state board of nursing, and NP scope and standards of practice. According to Federation of State Medical Boards (2005) and NCSBN (2009), à ¢Ã¢â€š ¬Ã…“SOP is a set of rules, regulations and boundaries within which a fully qualified NP may practiceà ¢Ã¢â€š ¬Ã‚ . It defines what activities a profession can undertake. Both practice acts (state regulatory board form of statutes approved by legislators) and its rules and regulations define NP SOP and require approval from legislators to become law. The Consensus Model for Advanced Practice Registered Nurses (APRN) Regulation was developed to resolve different issues concerning inconsistent APRN education and licensure requirement across jurisdiction and issues in certification. It helps stand ardize regulations for APRNs. Professional regulators are working together in implementing a consistent SOP for NPs in all jurisdictions. According to American Academy of Nurse Practitioners (AANP), NPs are licensed independent practitioners that provide nursing and medical services emphasizing on health promotion and disease prevention. In addition, NPs have a collaborative practice agreement with the physicians. However, regulations are different from state to state NP SOP are not clearly defined and further clarifications are needed especially as it pertains to NPs working in acute care to ensure that NPs are practicing according to their education, training and competency as evidenced by the certifications they hold. Running Head: NURSE-DIRECTED INTERVENTIONS TO REDUCE CATHETER-ASSOCIATED URINARY TRACT INFECTION This research focuses on the evidence-based practice guidelines conducted at the University of Colorado Hospital as a quality improvement project to initiate a nursing-driven approach to reduce the incidence of catheter-associated urinary tract infection and improve patient outcomes. A catheter-associated urinary tract infection (CAUTI) is the most common cause of healthcare-associated infection. It is a major health concern leading to prolonged hospital stay and increased healthcare cost. Evidence-based use of indwelling urinary catheter (IUC) must be enforced to reduce the prevalence of CAUTI. In this project, an intervention design was implemented to evaluate the nurse-driven intervention incorporating evidence-based guidelines. The goal is to decrease the prevalence CAUTI by emphasizing health education on specific unit-based nursing practice. Improving the nursing care by educating the nurses regarding insertion, management and early removal of IUC to ensure the best practice and expanding this education to ancillary services (eg. rehabilitation and transport staffs) were found to positively impact the CAUTI rates. Focused unit interventions such as providing education on postoperative catheterization, use of bladder scanner to check for urinary retention to minimize IUC reinsertion, and encouraging early removal of the urinary catheter were found to decrease the catheter days and prevent infection. Providing education by infusing the best evidence into current practice are important interventions to raise awareness. Incorporating evidence-based guidelines and strategie s by focusing of nursing-driven interventions can improve patient outcomes.

Coca Cola Marketing Mix

Coca-Cola Marketing Mix The marketing mix of Coca cola has been changing over time with more and more products being added such that today it has 3300 products, and many different ways of advertising all those products. But because of this Coca cola is the brand with the highest brand equity. The 4 P’s of Marketing: Product, Price, Place and Promotion Product This company has the widest range of beverages of 3300 products. The Beverages are divided into many groups with individual products in these groups, these are; diet category, 100% fruit juices, fruit drinks, water, energy drinks, tea, coffee and more.Coca cola is the No. 1 brand in sparkling beverages, juice, and retail packaged water. Coca cola has its market presence around 200 countries. Coca cola’s other brands are Fanta, Maaza, Limca, sprite, Thums up, Minute Maid, Nimbu fresh, Nested iced tea and more. Price Because of the availability of the many different products the pricing is done according to the marke t and geographic segment. Each different brand of Coca Cola has different pricing strategy. Their pricing strategy is based on the competitors pricing, Pepsi is the main competitor to coke.Beverage market is said to be an oligopoly market (few sellers and large buyers), that’s why they form into cartel contract to ensure a mutual balance in pricing between the sellers. Place Coca cola is the world’s most favourite brand and is available all over the world. Selling in mostly everywhere in the world, you can find all the favourite different brands of Coca Cola in every big chain super market and in most little shops like corner shops. Promotion Coca cola uses various advertising and promotional strategies to create an increased demand in the market.They do this by associating Coca Cola with life style and behaviour and mainly targeting value based advertising. You are more likely to see a coke ad being for a particular festival or in with a general positive message. Coca cola uses CSR as its marketing tool to gain emotional benefits in consumers mind. The current promotions through CSR include â€Å"Support my school† campaign with NDTV. It allows price discounts and allowances to distributors and retailers in order to push more products into the market.It employs both push strategy through promotions and pull strategy through advertisements and campaigns. Also uses children in many adverts to get children interested in their products too. One of their most successful promotion idea was with farther Christmas, before coca cola St. Nick was wearing green but because of coca cola he is now the fat jolly guy wearing red that we all know now. Coca Cola targeted the most loved worldwide celebrated day of the year and tuned that day’s idol into something they created and will always be a big promoting point to them.

The idea of anti-sexism has hardly scratched the surface of the popular male imagination

The usual view of men's anti-sexism is that it centres around men who find it personally important to challenge the pressure to conform to a ‘macho' image plus a handful of politically aware men wanting to assist on what are seen as feminist issues. In fact any man giving it serious thought will come to see domestic violence, rape, care of their children and suchlike as being men's issues. However, the average man will not be drawn into men's groups by these issues, and will tend to see men's anti-sexism as a movement without a cause. But I believe it's a movement which has remained marginal by failing to acknowledge its biggest cause. Men's groups tend to look for a personal response to the contradictions their members face – THEY are the problem, they must change. This seems to be unrelated to the impersonal world of politics and the hard realities of jobs, pay, working hours and conditions, etc. But this is exactly the area where anti-sexism could have its greatest impact. Because, in spite of the effects of massive unemployment, little has changed men's ideas about work. The classic picture of man-as-incomplete-person that men's groups invoke – emotionally retarded, distant from his children, competitive at work and dominant at home – describes a man well moulded to the career world. The stereotypical male values closely match the qualities desirable in competitive work. Despite the ‘personal politics' of a few men, the nature of work itself has not changed and continues to reinforce the same traditional male values. But there are now women working successfully in most professions – so why should male values continue to dominate? It is because of the strict division between full-time and part-time work. It's in full-time work in the majority of occupations that men and traditional values prevail – women in these jobs work on men's terms. Part-time work on the other hand is clearly the province of women – over 90% of part-timers in Britain is female. In fact, much of the recent increase in women's employment has been in the part-time sector. So what are the differences in these two areas of work? Full-time jobs are valued more highly, often paid a ‘family wage', and require the specialisation of skills and continued commitment that would merit the title ‘career' (though the principle is the same from bricklaying to brain surgery). This continuity is very important – women (in Britain) are permitted usually only a token break for maternity and men generally none for paternity. Outside this career world, there is both unpaid domestic work, including childcare, and formal part-time work – with pay, conditons, prospects and job interest generally worse than full-time work. There are two results of this duality of working situations. Firstly, because of women's unavoidable involvement in caring for their babies, career work favours men. Full-time work has changed little to accommodate the increasing number of women in it, who have to accept the limitations imposed by men such as avoiding children or delegating their care to the domestic/part-time sector. Secondly, the domestic and part-time workforce is not only economically inferior to the career sector but actually services its interests and sustains it. This relationship is the framework for exploitation of both capitalist and patriarchal nature. So, women having children must be free from work from late pregnancy until the baby is weaned at the very least. As men are generally not permitted any reasonable paternity leave it is necessarily the mother who continues to look after the child at least until school age (unless the parents are willing and financially able to pay someone else to do so). If these considerations did not keep the woman out of full-time work in the first place, they are likely to do so for some years at this stage, especially since this whole situation increases the likelihood that the father will be earning more than her at this financially critical time. While this rigid division of work exists, therefore, women wanting children will be disadvantaged in full-time work, and many women having children will have to accept the limitations of part-time work. Men, if they are able to get full-time work, will almost always take this in preference to part-time work – and when they become fathers are likely to be under financial pressure to keep their full-time job, at the expense of their involvement with their children. Some European men, notably in Belgium, have come up with ideas that could break down the rigidity of this full-time/part-time division. They have lobbied the European Parliament for the establishment in the EEC Constitution of what they call the Flexible Work Right. This would be the legal right of anyone to choose how many hours a week to work, being paid accordingly. It would be a move against the binding domination of full-time work and the undervaluing of part-time work, which would allow a balance of working and domestic life to suit the priorities of individual men and women. In particular, parents would be free to share childcare and earning according to their own values. A practical shift in the distribution of the tasks between the sexes would open the door to many other changes. If the responsibility for financial support was no longer borne principally by men this could undermine the damaging tendency for manhood to be measured by economic success – which is often won at the price of being a second rate parent. And for women, work on these terms would mean not only an increase in real economic power and independence, but with this a greater participation in public and political life. Also any overall reduction in average hours worked could help to reduce unemployment in the right circumstances. So how might these ideas be realised in practice? Three possibilities for change are better provision for job sharing, more flexibility of working hours (especially total hours worked) and better parental leave allowances. As far as trade unions are concerned, defending the interests (primarily financial) of those in work comes before freeing members to work less. So small reductions in the working week, (which would probably serve mainly to increase overtime payments), take priority over genuine flexibility of hours and job-sharing provisions. Some forward-looking unions ARE seeking better paternity leave – most men take some time off whether it is officially available or not (94% in a recent Equal Opportunities Commission study). Better parental leave entitlement would go some way toward the goals of this anti-sexist men's politics, especially since the right to flexible work will surely only be won in slow stages. And here the EEC is already playing a part. The EEC Commission has issued a directive aiming to set minimum standards for parental leave in all member countries (three months for men and women during the child's first two years, in addition to maternity leave and at no extra cost to employers). Despite agreement of all other members, and within Britain support of the House of Lords and the Equal Opportunities Commission, the British government has so far vetoed the passage of this Directive into Community law. So there's no doubt that some aspects of anti-sexist thinking are as political as they are personal. But the anti-sexist angle on work doesn't end there. Poor working conditions and occupational safety may be sustained by ideas of what is ‘manly'. The notion that men who complain of bad conditions and danger are soft is sexist and encourages mistreatment of workers – not to mention alienating and excluding women. The response to noise, pollution and heavy lifting may be headaches, ulcers, heart disease and backache; human conditions too are important – if work is a hostile or authoritarian place men may take it out in drinking or violence outside work. A humane workplace is essential for a humane world. The goals of this ‘men's politics' in fact complement those of feminism despite their separate and apparently selfish motivation. This motivation is crucial since the issue of work as a major limitation in their lives is one with which many could identify. This idea – men seeing themselves as ‘work objects' – paves the way for a wider view of anti-sexism, encompassing the aspects of personal change and ‘feminist' causes important to men's groups now. It would suggest too, a positive attitude of relating some of the less desirable trappings of maleness to the situations which shaped them, rather than blaming them on maleness itself. If men looked objectively at the unnecessary sacrifices they make on the altar of work, anti-sexism would suddenly seem relevant to many more men than the few involved at present. (C) Five Cram POSTSCRIPT The above article considers one interesting proposal for breaking down the male-dominated character of paid work. For example, as this issue went to press, a Bill introduced by the Labour MP Harry Cohen, which would introduce a statutory right to a period of parental care for parents of young children, was due to receive a second reading in the House of Commons. Under this Bill, employees with children under two years old (five if the child is disabled or adopted) would be entitled to 13 weeks paid leave if both parents are in paid work, 26 weeks if he or she is a single parent and 4 weeks if the other parent is ineligible for parental leave, for example because of unemployment. The entitlement is not transferable between the parents. The scheme would be paid for by employers and the Government. Under this Government – and probably any currently realistic alternative – it is unlikely to become law. I think it is an important step forward, but how can we as men help it to happen? Schemes of this sort, although less generous, already exist in ten of the twelve EEC countries – why not here? Even if employers, unions and the Government could be persuaded that this sort of parental leave provision is in their interests, there is a danger that it would divert attention away from the need to extend workplace nurseries and local authority childcare provision, and further privatise the provision of ‘care' in our society. Another important issue is how, ‘parental' schemes like this should be linked to more general ones like a Flexible Work Right. Which should have higher priority, and what would their effects be on the level of unemployment? Finally, I doubt if such voluntary schemes would be enough to bring about major changes in the distribution of labour between the sexes. Particularly in times of high unemployment and low wage increases, when the perceived priority of maximising the ‘breadwinners' earnings is greatest, many men would not willingly reduce their hours worked. Schemes involving paid leave avoid this problem, but inevitably involve smaller changes in hours worked so as not to be prohibitively expensive. Compulsory schemes, such as legal limits on basic hours of work and overtime (to encourage men to invest more time and effort in the home) would probably also be needed, but care would be needed to avoid reducing low-paid workers' wages oven further. But, to end on a positive note, it is true that there is a long-term trend towards fewer hours spent in paid employment by each male worker – the average has fallen by over one third in the last 100 years. Let's hope it continues and that employed men make good use of the growing part of their lives spent outside paid jobs.

Effects Of The Transatlantic Slave Trade Essay - 1291 Words

In 1510, King Ferdinand of Spain sent 200 Africans to his nation’s colonies in the Americas to clear land and to work rice, sugar, tobacco, and other crops. The African slaves resisted European diseases more than indigenous Americans and European indentured servants; and, readily adapted to agricultural work in tropical climates. As the African’s work proved fruitful, the Spanish and Portuguese soon entered into trans-Atlantic slave trade agreements with various ethnic nations in Africa to ensure a continual supply of labor for their expanding agricultural economies in Brazil, the Caribbean, and the Americas. In response to demands for African labor from other countries, the Spanish Crown developed a system of licenses, Asientos , that allowed merchants from Portugal, Holland and Britain to purchase slaves at wholesale costs that ranged from three dollars to twenty dollars. By the end of the 1500s, the extent and impact of the transatlantic slave trade surpassed the level of cruelty than any form of slavery that previously existed in Africa. When the Portuguese, Spanish, and Dutch transported over 200,000 people from Africa to the colonies in the Caribbean and the Americas. After 1663, the English intensified the slave trade after its investors formed the Company of Royal Adventurers, a slave trade conglomerate. By 1668, over a quarter of the company’s profits resulted from trading millions of slaves to the West Indies and Virginia. Many African nations stronglyShow MoreRelatedTransatlantic Slave Trade and the Effects on the American Economy1627 Words   |  7 PagesTransatlantic Slave Trade and the effects on the american economy Transatlantic Slave Trade The Transatlantic slave trade is a â€Å"wrenching aspect of the history of Africa and America† (Colin Palmer). The transatlantic slave trade transported African people to the â€Å"New World†. 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