The Health Care Industry

Introduction Health Care is a term used to refer to all duties geared towards provision of necessary measures concerned with human health. Such duties and services are normally provided through professionally trained medical personnel (U.S. Department of Health and Human Services). However, provision of medical services always requires adequate finances from the recipient for health stability to be maintained.Advertising We will write a custom proposal sample on The Health Care Industry specifically for you for only $16.05 $11/page Learn More This should be organized based on medical legislative policies and standards governing the healthcare system within specified regions or countries. The health care industry faces numerous challenges which require urgent and adequate address; these challenges are in form of costs as well as complex processes followed to ensure delivery of right services. Various economic effects also contributes towards rising costs on health insurance premiums, this has seen reduction in access to efficient medical care. Such factors have led to elimination of health care insurance services by most employers (U.S. Department of Health and Human Services). Summary of the selected chapter The chapter focuses on the challenges facing healthcare sector in the process of providing their services to individuals, this includes the provision of health care insurance it’s pricing and the effects on population. The healthcare industry comprises of several services including those given in hospitals, nursing homes, laboratories and health care experts. There are indeed numerous communication tools utilized by the caregivers which could help in the facilitation of health care provision. Such tools are capable of delivering necessary guidance and support hence assist in enhancing citizens’ confidence on their health care system and management. Health care management plans should be provided so as to help faci litate the processes of managing health conditions in an appropriate and consistent way based on medical personal plan. Several policies have been proposed by the United States concerning patient health protection based on affordable services (U.S. Department of Health and Human Services). Other countries also have systems concerning the same where national health insurance is paid by the government using tax revenues ensuring that individuals can access health services at affordable costs or no cost at all. However, in America the private health insurance is currently paid by the employers.Advertising Looking for proposal on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More This has had dire consequences to the population since health paid for in such manner could create intractable incentives which could lead to higher prices. The other problem also emerges on the regulation process which will require up-grading of the curre nt insurance system (Health Care 434). Health care costs require review to the extent of enabling consumers purchase their value for money services. Health care marginal benefits should be positive and of great benefit to the society. Rationing mechanisms might be utilized to ensure control on the cost of health care; even the use of non-price mechanisms such as offering health insurance could be utilized. The United States applies the use of government insurance regulation which has had both positive and negative impacts (Health Care 443). Supply of medical practitioners is also raising concerns since despite increase in number of physicians; their services fail to meet the demand of the American population. Technological changes within the medical field have also affected the industry by lowering costs such as reducing lengths of stay in hospitals but at the same time some technological advances have significantly increased the prices of services offered (Health Care 444). In addi tion, there is also emergence of managed-care organizations which assists in controlling costs of medication ensuring that all citizens irrespective of their social status reduces their health care expenditures. Moral Hazard Problem This problem involves the issue when one party alters the agreement signed between two parties in a way that is costly and detrimental to the other party. There are several inefficiencies prevalent within the health care system. Such include fraud and abuse cases against patients by the medical staff in exposing confidential medical information concerning individuals. According to medical ethics it is always necessary for Health information obtained from patients to be personalized and kept confidential as per the agreement between the patient and the medical practitioner. This offers some confidence on the side of the patient hence expresses readiness to seek more and more medical counselling. Patients’ medical reports should always be handled wi th lots of caution and every effort applied to ensure their protection since it can either act as source of encouragement or discouragement depending on how such information is handled by the experts. Exposing medical information concerning patients with certain diseases may lead to social discrimation within the job market (Health Care 434-484).Advertising We will write a custom proposal sample on The Health Care Industry specifically for you for only $16.05 $11/page Learn More From another perspective health care insurance at times causes people to react in different ways. It at times makes people to be reluctant on the issues concerning their personal health hence not paying much attention on preventive measures. The insurance cover also makes individuals at times to breach their integrity on the use of medical incentives. They are times when individuals are tempted to use healthcare frequently than expected compared to when there is no provision on insurance coverage. Weak security accorded to patient’s medical information could be attributed to lack of appropriate information system technology. However, with the improvement in technological know-how, high standards of ethics and technology are applicable for the confidentiality purposes in all sectors within the industry. Such standards are expected to be maintained within organizational bodies such as healthcare clearinghouse concerned with data retrieval and compilation. This should happen for the purposes of building good rapport between individuals and medical specialist (Health Care 434-484). Falsification of medical records should be treated with a lot of concern. All the records need to be straight including those of third parties. The manner in which medical records as well as financial records are handled within health institutions determines to a large extent the level if investors interests in providing support to healthcare system. All entries for every tra nsaction should be shown for accountability purposes as well as maintaining financial integrity. Financial management within the health care industry should be realigned to reflect the standards based on Generally Accepted Accounting Principles. GAAP ensures that the right financial procedures are applied and followed by all medics in relation to organization’s activities, calling for their full cooperation in providing valid information (U.S. Department of Health and Human Services) Inappropriate information on financial records should lead to direct termination of the concerned employee. Un-ethical practices within medical field in line with financial management include; alteration of true financial transaction figures, inappropriate entries on income and expenditures, maintenance of fraudulent accounting reports and documents, recording any payments outside those described within the confines of the hospitals’ rules and regulations and forgery of signatories (U.S. D epartment of Health and Human Services).Advertising Looking for proposal on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Integrity of healthcare institutions revolves around the reputation of its employees. Medical organizations should not allow personal financial inducements to control their overall professional performances on administering appropriate treatment. All activities and practices should be performed under the guidance of already set ethical principles. Various core values guarding individual services within medical institutions should be observed even by the various medical associates, like pharmacists and medical engineers (U.S. Department of Health and Human Services). Solution to the problem The problem could be addressed through enforcement of ‘Health Insurance Portability and Accountability Act (HIPAA) of 1996’ (HIPAA) security which applies comprehensive address on the legislative procedures concerning individual health policies (Rada). The policy enables easy identification of fraudulent activities within the health care industry, and also protects patients from such abuses as job discrimination. The statute enables Americans to easily access health insurance benefits since it makes easy insurance portability processes. All individual medical documents are transformed into reports which are easily approved by the concerned organizational bodies dealing with medical reports. The procedure is used in keeping policy records with high level of confidentiality and ensures maintenance of integrity. There is also provision on the necessary fines imposed on individuals upon breaching of the policies within the statute. Managed-care organizations work closely with the statute in ensuring that patients are well served by various physicians despite looming disadvantages provided by the policies. There should be no denial of highly effective treatment based on the prices charged by the medics, this would ensure that proper insurance services are extended to millions of people within the United States (U.S. Department of Health and Human Services). Works Cit ed Health Care. Microeconomics Issues and Policies. NY: Health Administration Press, 2010. Print. Rada, Rodgers. How HIPAA Compliant Can Any Technology Be?† HIPAA Advisory: Phoenix Health Systems. Web. 2010 Web. U.S. Department of Health and Human Services. â€Å"Security and Electronic Signature Standards; Proposed Rule.† The Federal Register, 63.155 (1998): 43242-43280. Web. This proposal on The Health Care Industry was written and submitted by user Sylas B. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

World War II Essays - World War II, Military Strategy, Free Essays

World War II Essays - World War II, Military Strategy, Free Essays World War II In the early morning hours of September 1, 1939, the German armies marched into Poland. On September 3 the British and French surprised Hitler by declaring war on Germany, but they had no plans for rendering active assistance to the Poles. The Battle of Britain In the summer of 1940, Hitler dominated Europe from the North Cape to the Pyrenees. His one remaining active enemy?Britain, under a new prime minister, Winston Churchill?vowed to continue fighting. Whether it could was questionable. The British army had left most of its weapons on the beaches at Dunkirk. Stalin was in no mood to challenge Hitler. The U.S., shocked by the fall of France, began the first peacetime conscription in its history and greatly increased its military budget, but public opinion, although sympathetic to Britain, was against getting into the war. The Germans hoped to subdue the British by starving them out. In June 1940 they undertook the Battle of the Atlantic, using submarine warfare to cut the British overseas lifelines. The Germans now had submarine bases in Norway and France. At the outset the Germans had only 28 submarines, but more were being built?enough to keep Britain in danger until the spring of 1943 and to carry on the battle for months thereafter. Invasion was the expeditious way to finish off Britain, but that meant crossing the English Channel; Hitler would not risk it unless the British air force could be neutralized first. As a result, the Battle of Britain was fought in the air, not on the beaches. In August 1940 the Germans launched daylight raids against ports and airfields and in September against inland cities. The objective was to draw out the British fighters and destroy them. The Germans failed to reckon with a new device, radar, which greatly increased the British fighters' effectiveness. Because their own losses were too high, the Germans had to switch to night bombing at the end of September. Between then and May 1941 they made 71 major raids on London and 56 on other cities, but the damage they wrought was too indiscriminate to be militarily decisive. On September 17, 1940, Hitler postponed the invasion indefinitely, thereby conceding defeat in the Battle of Britain. U.S. Aid to Britain The U.S. abandoned strict neutrality in the European war and approached a confrontation with Japan in Asia and the Pacific Ocean. U.S. and British conferences, begun in January 1941, determined a basic strategy for the event of a U.S. entry into the war, namely, that both would center their effort on Germany, leaving Japan, if need be, to be dealt with later. In March 1941 the U.S. Congress passed the Lend-Lease Act and appropriated an initial $7 billion to lend or lease weapons and other aid to any countries the president might designate. By this means the U.S. hoped to ensure victory over the Axis without involving its own troops. By late summer of 1941, however, the U.S. was in a state of undeclared war with Germany. In July, U.S. Marines were stationed in Iceland, which had been occupied by the British in May 1940, and thereafter the U.S. Navy took over the task of escorting convoys in the waters west of Iceland. In September President Franklin D. Roosevelt authorized ships on convoy duty to attack Axis war vessels. The German Invasion of the USSR The war's most massive encounter began on the morning of June 22, 1941, when slightly more than 3 million German troops invaded the USSR. Although German preparations had been visible for months and had been talked about openly among the diplomats in Moscow, the Soviet forces were taken by surprise. Stalin, his confidence in the country's military capability shaken by the Finnish war, had refused to allow any counteractivity for fear of provoking the Germans. Moreover, the Soviet military leadership had concluded that blitzkrieg, as it had been practiced in Poland and France, would not be possible on the scale of a Soviet-German war; both sides would therefore confine themselves for the first several weeks at least to sparring along the frontier. The Soviet army had 2.9 million troops on the western border and outnumbered the Germans by two to one in tanks and by two

5 Minute Speech Topics on Euthanasia

5 Minute Speech Topics on Euthanasia 5 Minute Speech Topics on Euthanasia Writing about euthanasia is important because it is a currently debated topic, one about which laws are being made. It is therefore essential to understand some history behind the issue, how it is relevant today. If you are assigned with a 5 minute speech on this issue, then you can consider yourself quite lucky. Here you have 5 minute speech topics that are relevant and really interesting. After selecting one from the list, you need to define the purpose of your speech. The purpose might be to inform the readers or to persuade them. If you need help finding the topic you will use, consider the 20 examples below. Remember too that these are meant as guiding examples, and you might find one you want to use as it is, or one you want to slightly edit before putting it into use: Neil Campbell’s Problem with Voluntary Euthanasia Legislative Barriers to Legalizing Euthanasia Age Limitations to Access Legal Euthanasia Why Certain Conditions and Diseases Should Prohibit People from Choosing Euthanasia The Social Cost of Euthanasia Forced versus Voluntary Euthanasia: Which Is More Ethical The Psychological Burden on Medical Staff Administering Euthanasia The Ethics of Media Coverage for Voluntary Euthanasia Cases How Euthanasia Can Reduce Medical Costs: Circumventing Life Support and Its Expenses The Loss of Dignity and Self-Respect: When Euthanasia Is a Saving Grace Cultural Arguments Against Euthanasia: Why Not Everyone Can Agree Voluntary Euthanasia: A New Chapter for Capital Punishment Religions and Euthanasia: Where the Boundaries Lie Individual Freedom: When States Can Encroach upon It by Prohibiting Euthanasia Re-Considering Euthanasia as a Cure for Traditionally Incurable Diseases Dying with Dignity: The Argument for Euthanasia Ancient Greek Mercy Killings and Abortions: The Historical Roots of Euthanasia Euthanasia: The Right to Die The Freedom to Live, But Not to Die: The Constitutionality of Euthanasia Re-Defining the Role of Doctors: Bringers of Death The writing process can be long and arduous, but have no fear. By breaking it into smaller tasks it will be much easier to complete it in a timely fashion. With a 5 minute speech, you want to make sure you cover the key points thoroughly, without talking too quickly. You should practice timing yourself after you write your draft so that you know how much time you will use. After you have written the piece, you need to take a break. It is important that you complete this process by looking for one thing at a time. If you try to look for everything all at once by reading through your final document a single time, you are sure to miss things but if you take time to read through it once for spelling, once for grammar, once for organization, etc. then you will find that things magically fall into place. Our academic writing company is committed to provide students with high-quality custom speech writing service available always online.

The unique features of Newar Buddhism and their development Essay

The unique features of Newar Buddhism and their development - Essay Example This study will be concentrated on the special features of Newar Buddhism with regard to its organizational structure and major activities of its Sa-gha . In order to outline and evaluate the complex connections among the many important factors, this discussion shall be divided into three parts. A brief historic synopsis will give a general overview of the evolution of Buddhism in Nepal. Then the relevant features of Newar Buddhism, with respect to its own evolution, shall be presented. Finally, in the last part, there will be made an attempt to evaluate the influence of these features on the decline of Newar Buddhism. The mythology of Nepal reaches far back to countless eons, accounting for the lives of twenty-four previous mortal Buddhas4. According to the myth, the Katmandu Valley was a lake before Maà ±juÅ›rÄ « drained it with his sword to make it inhabitable. However, even in more recent times legends have remained difficult to separate from historic facts.5 The first of the five historic periods of the Katmandu Valley lasts until the 5th century AD and includes mythical and semi-mythical dynasties, such as the GopÄ la, the AhÄ «r and the KirÄ ta6. At least the KirÄ ta are known from traditional chronicles, and are said to have ruled the Katmandu Valley during the time of ÅšÄ kyamuni Buddha. The first major Indian power that recorded in relations to the Katmandu Valley was the early Gupta dynasty (1st – 4th century AD).7 Whereas Ashoka’s earlier visit to Kapilavasu in the 3rd century BC is accepted by historians, his alleged visit to the Katmandu Valley is not. The second period refers to the rule over a small area within the Katmandu Valley by the aristocratic Licchavi family (about 464 – 880 AD), which is known as the first line of Nepalese kings.8 The Chinese pilgrim Hsà ¼an-tsang recorded that various monasteries (Skt vihÄ ras) existed9 in the 7th century side by side with Hindu temples.

The American Constitution Research Paper Example | Topics and Well Written Essays - 2250 words

The American Constitution - Research Paper Example The Anti-Federalists, those opposed to the proposed constitution, included John Hancock, Samuel Adams, and Patrick Henry who also wrote a series of essays now referred to as the Anti-Federalist papers. They were fearful the will of the states would be dominated by the potential authority of centralized federal government. The Federalists attempted to reassure the doubters that they did not intend to create a governing system much like the tyrannical in British system which the colonists had just fought a protracted war to escape. The Anti-federalists ensured this stated intention by opposing the Constitution as written and insisting it contain further clarification of civil liberties by inserting the first ten Amendments, the Bill of Rights. The first ten amendments to the Constitution, the Bill of Rights were crafted as a compromise that was forged between the two differing viewpoints. The terminology describing these divergent viewpoints is somewhat misleading. The Anti-Federalists could actually be better described as federalists because they wanted the government to be a federation of independent states. Federalists would be better defined as Nationalists because they wanted an authoritative federal government. This paper examines the point of view of both Federalists and Anti-Federalists and the method by which they reached a compromise after two years of contentious debate and an explanation as to why one was ultimately the best choice. The Necessity of the Constitution The Federalist Papers expressed the limitations of the loosely associated union between the states that was present at the time as well as the benefits of uniting the states into an efficient central government. The Federalists were wealthy business and land owners who believed that a powerful centralized federal government governed by influential, learned persons would promote commerce which was both to their and the country’s benefit. John Jay specified this reason first over all other motives to unite the states by ratifying a constitution in the second of the Federalist Papers, â€Å"It has until lately been a received and uncontradicted opinion that the prosperity of the people of America depended on their continuing firmly united, and the wishes, prayers, and efforts of our best and wisest citizens have been constantly directed to that object† (Jay, 1787: Fed. #2). The Federalists’ interests were positioned principally in a robust economy which they argued would contribute to the security and prosperity of all citizens. It is probable that at least part of their motivation to create a strong federal government was their own economic interest. Essentially, the Papers defended the idea of republicanism within the Constitution. In addition to financial advantages, the Federalists made a persuasive case for the forming of a powerful federal government by emphasizing the necessity for securing and preserving the lives, liberty and property of th e new nation’s citizens. By combining interests and resources, the military and economic weaknesses of the loosely allied states would be significantly strengthened which would act to safeguard the entire country from both internal and external dissension. The nation as a whole would become less susceptible from a

Intravenous therapy is an infusion of medicine and fluids into vein

Intravenous therapy is an infusion of medicine and fluids into vein BACKGROUND OF THE STUDY Intravenous therapy is an infusion of medicine and fluids into a vein. IV therapy is essential part of clinical use. There are also complications which included in IV infusion are local and systemic, local include thrombophlebitis, infiltration, extravasations, nerve injury and systemic include bacteremia, septicemia, emboli, thrombus, circulatory overload etc . Thrombophlebitis,Thrombo means clot Phlebo means vein and itis means inflammation. Thrombophlebitis refers to the presence of a clot plus inflammation in the vein. Phlebitis is defined as the acute inflammation of internal lining of the vein Infusion Nursing Standards of Practice (2000). According to international association of pain (IASP) (1994), pain is an unpleasant sensory experience associated with actual and potential tissue damage. The pain is classified as nociceptive, neuropathic, acute and chronic pain. The nociceptive pain is caused due to damage to somatic or visceral tissue damage which pain from surgical incision ,a broken bone, or arthritis ,the neuropathic pain is caused by damage to peripheral nerves or CNS which include trauma, inflammation ,metabolic diseases like diabetes mellitus, tumors, toxins, and neurologic diseases such as multiple sclerosis and acute pain is dure to post operative pain ,labour pain, and pain from trauma and the chronic pain is for longer periods due to cancer. Pain is a highly unpleasant and professional sensation that cannot be shared with others. It can occupy all a personal thinking, direct all activities and change a person. Yet pain is a difficult concept for a client to communicate. Pain is universal experience its exact nature becomes mystery. Unrelieved pain presents both physiological and psychological hazards to health and recovery. Care givers should include assessment of pain as a fifth vital sign to emphasize its significance and to increase the awareness among the health care professional of the importance of effective pain management. There are many non pharmacological measures which is provided including massage, exercise, transcutaneous electrical nerve stimulation, percutaneous electrical nerve stimulation, accupunture heat therapy, cold therapies, and cognitive therapies including distraction ,hypnosis and relaxation strategies. Edema which is the accumulation of fluid in subcutaneous tissue due to extracellular volume expansion. There is swelling of tissues which can be demonstrated by pressing lightly with the thumb over a bony prominence especially on dorsum of feet and around the ankles. The types of edema include hydrostatic edema, oncotic edema, inflammatory and traumatic edema and lymphatic edema. Phlebitis can be classified into 3 three categories which include mechanical, chemical and bacterial where mechanical is due to the size of cannula is too big for the selected vein causing unnecessary friction on the internal lining leading to inflammation, chemical phlebitis is due to peripheral IV devices when the medication or solution irritate the endothelial lining of the small peripheral vessel wall and bacterial phlebitis is usually precursor to an infection at the infection site. Thrombophlebitis is evident by localized pain,redness, warmth, and swelling around the insertion site or along the path of the vein,immobility of the extremity because of discomfort and swelling. Non pharmacological treatment includes discontinuing the IV, applying a warm compress, elevating of the extremity, and restraining the line in the opposite extremity .In the presence of signs and symptoms of thrombophlebitis, one should not attempt to irrigate the line. Pharmacological and non pharmacological agents are available for relief of pain, edema and inflammation. The cost and side effects are comparatively high in modern medicine. The number of client seeking unconventional treatment has risen considerably. Nonpharmocological therapies, natural therapies, cryotherapies, and aromatherapies are available with less expensive and fewer side effects. Likewise in combact aloveragel is also very much used in reducing pain, edema and severity of inflammation. For local treatment in order to relieve pain, edema and severity of inflammation alovera gel can be used. Since in the era of Ancient Egypt humans having using aloe. They used one of the ingredients of embalming fluid. In the tenth century, the Europeans were introduced, where it became an important ingredient in many herbal medicines. By the sixteenth century, aloe arrived in the West Indies, where still today it is harvested. Alovera is one of the therapeutic herbs as a healing plant. The uses of aloe of popularized in 1950s itself.There are over 300 different types of aloe, but only a few were used traditionally as an herbal medicine. In the middle ages the yellowish liquid found inside the leaves was a favored as purgative. Aloevera gel is the mucilaginious gel produced from the centre (the parenchyma) of the plant leaf. It contains 400 species.The gel portion of the plant is prepared by peeling the outer portion of the skin and the pericap away. It is preparation which is called pure aloevera gel in commerce. Aloevera is thick, tapered with spiny leaves grow from a short stalk near ground level. It is not a cactus, but a member of the tree Lilly family known as Aloe Barbandesis. Some species , in particular Aloevera are used in alternative medicine and in home first aid .Both the translucent inner pulp and the resinous yellow exudates from wounding the Aloe plant are used externally to relive skin disc omforts. The gel found in the leaves is used for soothing minor burns, wounds and various skin conditions like eczema and ringworm. Aloevera gel has both antimicrobial and anti-inflammatory effects. The constituents include gibberlin,lectins,lignins,glucose ,mannose, glucuronic acid other polysaccharides including galctogalacturans and galactoglucoarabinomannas.The most abundant constituents is water(99%).The aloevera gel contain anti-inflammatory agent gibberlin and polysaccharides which effectively decrease inflammation and promote healing.Aloevera effectively relieves pain because it contain salicylic acid .Aloevera contain ligin which helps to penetrate deeply into skin to deliver its therapeutic effects. Most of the nursing interventions fit comfortably within the real of the natural therapys the illness healing paradigm shift and converge, and role of nurses shifts can gives to the healer. Therefore aloevera gel could be a suitable intervention which helps the nurse to reduce pain, edema and phlebitis. NEED FOR THE STUDY IV therapy has become a pervasive world wide as a routine therapy. Nurses yearly still insert, use and monitor millions of peripheral venous catheters (PVC).To diagnose and assess phlebitis severity is essential as a way to prevent a host of severe complications such as septic phlebitis, bacteremia, septicemia, arthritis, osteomyleitis eventually leading to death. However it is still prone to associated complications, of which phlebitis is most common, with prevalence varying between 20% to 80% Workman (2000). Villicampa (2008)Spanish review a national multicentric epidemiological study having the institutional participation of 10 centres. In this study 381 complications appears in the 2701 peripheral catheters studied which represents an incidence level of 14.11%.They reviewed 8700 treatment records this study proved that implementation of strategies to improve the quality of care reduces non instrumental complication persistent pain at the entrance point ,extravasations of edema, second or third degree phlebitis and infection associated with catheters. Nassaji Zaveareh (2007) conducted a prospective study on peripheral interventions catheter related factor .In this study 300 patients admitted to medical and surgical wards from April 2003 to Feb2004 were participated. Variables evaluated were age ,gender, site and size of catheter ,type of insertion and underlying condition were observed for 3 days continuously. Out of that 26 % occurred phlebitis . There were no significant relationship between age catheter bore size trauma and phlebitis. Related risk factors were gender,ie.,female site and type of insertion of catheter, diabetes mellitus and burns. Important role of nurse is to control pain that of thrombophlebitis. The quality of care received in the hospital was often reflected in client care. Among paramedical profession, nursing personals were inserting intravenous line, monitoring, administering intravenous fluids and administering medicines. Maintenance of peripheral intravenous cannulae and removal of peripheral cannulae was an integral component of nursing care. Nordell, et al.,(2002)in a study of 52 patients, found 5 diagnosed cases of thrombophlebitis (10% ) .Out of fifty two patients twenty six hand or wrist venipunctures, he found 3 with thrombophlebitis.Also he had done Fifteen forearm punctures produced the other 2 cases of phlebitis while of the eleven patients undergoing antecubital fossa venipuncture, none were found to have developed thrombophlebitis. The reported incidences of thrombophlebitis vary from a low of 2% 21 up to 15%.33.One well-controlled Swedish study of over 1000 cases reported venous complications of many types at 31% is having thrombophlebitis. Singh , Bhandary ( 2007) , Dhulikhel Hospital Kathmandu University Teaching Hospital, Nepal carried out a prospective observational study to determine the occurrence of peripheral intravenous catheter related phlebitis and to the possible factors associated to its development.A total 230 patients under intravenous catheter were selected peripheral infusion site was examined for signs of phlebitis once a day using jackson Standard visual phlebitis scale and the result obtained was 136(59.1%)patients developed thrombophlebitis. Related risk factors as found in the present study were insertion site (forearm), size of catheter (20G) and dwell time (>=36 hours). There were higher incident of phlebitis among the client with Intra venous drug administration and especially between ages 21 40 years. Therefore more attention and care are needed in these areas by the care provider. In another study the overall phlebitis rate was 39%. Phlebitis developed in 53% of patients with short lines, in 41% of patients with midsized lines, and in 10% of patients with long lines, and these catheters remained in place an average (Â ± SD) of 3.0 Â ± 2.4 days, 4.6 Â ± 3.4 days, and 7.8 Â ± 6.6 days, respectively. The variables that influenced the development of phlebitis, as determined by multivariate analysis, type of catheter, blood hemoglobin levels, and IV therapy with either corticosteroids or erythromycin Lutter et al.,conducted a retrospective survey to identify the complication of venous catheterization in the left lower limb and right lower limb for 1,143 patients. Patients occurred phlebitis in 56% in left lower limb 51% in right lower limb. Aloevera has salicylic acid which include in analgesic effects, it contains ligin which helps to penetrate deeply into skin to deliver the therapeutic effects, it contain anti-inflammatory agent gibberlin and polysaccharides which decrease inflammation and promote healing. Netherlands, conducted a prospective study on treatment of superficial thrombophlebitis with aloevera gel in relieving the local pain, swelling and redness. In this 116 patients were selected with thrombophlebitis and applied for a period of 3 days. The efficacy of aloevera was recorded. There is a drastic improvement in patient received aloevera gel as treatment than the control group Winchers IM (2005). The investigator selected this study because during her clinical experience has observed the many patients who had admitted in the hospital with cannula, developed the catheter related complications such as blockage, pain, redness and thrombophlebitis. This incidence insists the investigator to do some intervention to overcome this problem. Nurses need to be equipped with current interventional skills in relieving the pain, edema severity of inflammation and to prevent and treat complications.Hence the investigator interested in assessing the effectiveness of aloveragel in thrombophlebitis patients in reducing pain, edema, and severity of inflammation. STATEMENT OF THE PROBLEM: A study to assess the effectiveness of aloveragel in reducing pain, edema and severity of inflammation among thrombophlebitis patients in selected hospitals at Kanyakumari District May 2010. OBJECTIVES To assess the pretest level of pain, edema and severity of inflammation for the experimental and control group. To assess the post test level of pain, edema and severity of inflammation in experimental and control group. To compare the pre test level of thrombophlebitis between experimental and control group. To compare the posttest level of thrombophlebitis between the experimental and control group. To compare the pre and post test level of thrombophlebitis for both the experimental group. To compare the pre and post test level of thrombophlebitis for both the control group. To associate the post test level of thrombophlebitis of the experimental and ontrol group with their selected demographic variables. OPERATIONAL DEFINITION Assess Systematically and collecting, validating and communicating the patient data. Effectiveness: In this study effectiveness means reduction of pain and edema and severity of inflammation of thrombophlebitis patients after the administration of aloveragel. Pain Refers the discomfort and irritability felt by the patient intravenous infusion site due to inflammation of vein and it is assessed by numerical pain scale. Edema Refers to the swelling in the infusion site and assessed by edema scale. Phlebitis: Refers to the redness which is occurred due to the intravenous infusion and is assessed by phlebitis scale. Aloeveagel: Refers to green leaves when it is teared which contain semi solid liquid and is applied in affected site. ASSUMPTION Pain,edema and severity of inflammation among thrombophlebitis can be reduced in adults by applying Aloveragel. Patient with thrombophlebitis at intravenous infusion site have pain , edema and inflammation . HYPOTHESIS RH1 There is a significant difference in pre test level of pain, edema and severity of inflammation between experimental and control group. RH2 There is a significant difference in post test level of pain, edema and severity of inflammation between experimental and control group. RH3 There is a significant difference in pre and post test level of pain, edema and severity inflammation among thrombophlebitis patients in experimental group. RH4 There is a significant difference in pre and post test level of pain, edema and severity of inflammation among thrombophlebitis patients for control group. RH5 There is a significant association of post test level of pain, edema and severity of inflammation among thrombophlebitis patients with their selected demographic variables (age, sex, site,duration etc). DELIMITATION The study is delimited for 4 weeks of data collection. The study is limited to a sample of 60 adults. CONCEPTUAL FRAME WORK Conceptual model presents certain views of phenomena in the world that have profound influences on our perception of that world. A model is a simplification of reality or representation of reality. Concepts in the model builds consider relevant and as aids to understanding. The study is mainly focused to find out the effectiveness of aloeveragel in reducing pain,edema and severity of inflammation among thrombophlebitis patients. In order to reduce pain,edema and severity of inflammation aloveragel was applied. The investigator adopted the Kings Goal Attainment theory (1980) as a base for developing the conceptual framework. Imogene Kings Goal attainment theory is based on the personnel and interpersonal systems, including interaction, perception, communication, transaction, role, stress, growth and development, time and action. PERCEPTION: Refers to person representation of reality. It is universal yet highly subjective and unique to each person. Hence the investigator perception was peoples may have pain,edema and severity of inflammation JUDGEMENT: The investigator judged that application of aloeveragel reduces pain,edemaand severity of inflammation thrombophlebitis patients. The investigator to judge the need to reduce the level of pain,edema and severity of inflammation. ACTION: The investigator applied aloeveragel. The thrombophlebitis patient willingness to accept aloeveaagel and participate in the study. REACTION: The investigator and to asset mutual goal setting. INTERACTION: Refers to verbal and non verbal behavior of individual and the environment or two or more individual with a purpose to achieve goal. It includes the goal directed perception and communication. Here the investigator interacts with the thrombophlebitis patient by giving aloeveragel applied 3 times per day. TRANSACTION: Refers to an observable, purposeful behavior of individual interaction with their environment to achieve the desired goal. At this stage the investigator analysis the pain,edema and severity of inflammation among thrombophlebitis patients in order to administer aloeveragel application.The positive outcome in post test is the reduction of pain,edema and severity of inflammation which indicate the aloeveragel application. OUT LINE OF THE REPORT The report is divided into 6 Chapters: Chapter I dealt with background of the study, need for the study, statement of the problem, objectives, operational definitions, research hypotheses, assumptions, delimitations of the study, conceptual framework and outline of the report. Chapter II relates with review of related literature pertaining to various areas of study. Chapter III contains with the research design, variables, setting of the study, population, sample, sample size, sampling technique, criteria for sample selection, development and description of the tool, content validity, reliability of the tool, pilot study, procedure for data collection and analysis of the study. Chapter IV presents the data analysis and interpretation of data Chapter V relates with discussion based on the findings of the study. Chapter VI includes summary, conclusions, nursing implications, limitations and recommendations of the study. The report ends with bibliography and appendices.

Effective Leadership through Communication Essay

An effective leader with a team of multicultural and multilingual individuals, requires basic skills in communication. This paper discusses some basic types of communication and a possible methodology to ensure that the communication is understood. Communication in different forms Firstly it is important to having a basic understanding of communication, Bonvillain discusses this when she states that language is: â€Å"The primary means of interaction between people. Speakers use language to convey their thoughts, feelings intentions and desires to others. Bonvillain then goes on to say that: ‘We learn about people through what they say and how they say it; we learn about ourselves through the ways that other people react to what we say; and how we learn about our relationships with others through the give and take of communicative interactions. ’ (N. Bonvillain, 2003 Language Culture and Communication, p. 1) Jeanne Brett, Kristin Behfar, and Mary C. Kern discuss communications within teams and further analysis the categorisations in a 2006 Harvard Business Journal: â€Å"People tend to assume that challenges on multicultural teams arise from differing styles of communication. But this is only one of the four categories that, according to our research, can create barriers to a team’s ultimate success. These categories are direct versus indirect communication; trouble with accents and ? uency; differing attitudes toward hierarchy and authority; and con? icting norms for decision making. † Both of these statements support that communication can be broken down in to different categories, but the categories differ depending on the context. In my opinion whether the communication is verbal (spoken language) or non-verbal (gesture or body language) or contextual (shared experience), discovering new cultures through experience rather than theory is not without its difficulties, small signals, that may easily be missed, can be key to the formation of a successful team. For example in southern India the simple act of saying thank you can leave an individual offended, this is because â€Å"thank you† is something a senior would say to a junior employee at work to show a power status, and so an individual thanking a peer would be impolite where as in the UK individuals are taught to say thank you from an early age for all transactions. An extremely common gesture in India is the head nod or wobble, this gesture does not necessarily relate to a yes or no response, it can mean â€Å"ok†, â€Å"I hear you speaking† or â€Å"I understand† this can be confusing and one individual in the conversation may not understand the route the conversation has taken if they are not aware of this gesture. This is supported in further research: â€Å"Communication in Western cultures is typically direct and explicit. The meaning is on the surface, and a listener doesn’t have to know much about the context or the speaker to interpret it. This is not true in many other cultures, where meaning is embedded in the way the message is presented. † (Jeanne Brett, Kristin Behfar, and Mary C. Kern Harvard Business Journal, 2006) As with the head nod the use of the smile can differ greatly wherever you are. In India I have been invited to a few weddings; it is the tradition here for the reception to be held prior to the ceremony. The reception consists of the Bride and Groom standing on a stage and all the guests joining them to have a photo taken, in these photos, no one smiles. From my research this is because, for the Bride this can be an unnerving experience, she is about to leave the comfort surroundings of her home, and step in to a new world of her husbands, the bride has been taught to appear shy, and the friends and relatives are respecting that tradition. Depending on the culture a smile can mean different things. In the German culture, according to Nees, a smile â€Å"is used with far more discretion, generally only with those persons one knows and likes† (Nees 2000. P. 93) where as in Korean culture, too much smiling is often perceived as the sign of a shallow person. Dresser notes that this â€Å"lack of smiling by the Koreans has often been misinterpreted as a sign of hostility†. (Dresser, 1996. 21). Challenge: How to manage when in the field In my opinion it is the reaction to these misunderstandings or communication barriers that is the key to the success or failure of the interaction, how the Team Leader reacts and the attitude they exhibit is the difference between learning the greater complexities of an individual’s culture and offending them. This is discussed further on in the paper, in techniques and tools. To ensure the success of a multi-cultural team a single unifying objective needs to be understood by all, Cartmill discusses this point: â€Å"Language lets us get vast numbers of big, smart fellow primates all working together on a single task – building the great wall of China or fighting World War 2 or flying to the moon. † (M. Cartmill, 1998, Gift of Gab p. 56) Putting this in the context of a Raleigh programme the objective remains the same for all, this is to complete a 3 month programme volunteering in remote communities whilst contributing to sustainable development. Although the end goal may be the same, the driving force or the motivation for each individual will be wildly different. For example one individual entered the Expedition to personally develop his social skills by living with a group of people in close proximity and to be taken out of his comfort zone; another individual wanted to be taken seriously and no longer seen as the group clown. For a Team Leader to be successful it is important that they understand the overall group objectives and individuals motivations, that the team leader has open communication channels with all individuals within the team, and that the individuals have the opportunity to share and express their own culture and identity. The Cambridge Encyclopaedia of Language states that: Cheering at a football game, reciting the Pledge of Allegiance, or shouting names or slogans at a public meeting can both re-enforce your group identification and reveal a great deal about you – in particular your culture, regional origins, social background, education level, occupation, age, gender and personality. (Crystal, the Cambridge Encyclopedia of Language, 1997. 13) A Team Leader can achieve this by using the structured personal development journals. The journal breaks down the expedition in to the 3 phases and askes appropriate questions to help the volunteer to think about and express their motivations and aspirations of the expedition. Once the volunteer fills the appropriate section the Team Leader has 1:1 sessions with all individuals in the team, this gives the individual time with the Team Leader specifically to discuss their development and any support they require from the Team Leader, this is also an opportunity for the Team Leader to provide feedback. By having this conversation and writing it down it provides a chronological account of the volunteer’s time on programme thus showing their journey through development and achievements. The Team Leaders and Day Leaders also run group sessions through facilitated reviews, to inform group bonding. E Griffin talks about this in A First look at Communication Theory (1994. p173) It is a very natural inclination when meeting someone to talk about a topic that both parties might enjoy; and should those talks prove interesting, it is equally natural for friendships to form and evolve. The more points of contact you can establish, the more comfortable you feel. Secondly facilitated sessions with the team over the first few weeks to unite them as one team, simple tasks such as a group contract and discussing â€Å"house rules† provides boundaries and a framework for individuals to work from, by doing this through facilitation the team are setting their own boundaries and gaining an understanding of each other, thus also providing a platform to challenge each other if the boundaries are breached. Techniques: Facilitation, Eric Burnes tools A useful tool or methodology I have found is Eric Burne’s Transactional Analysis (TA). In its most basic form the model teaches that there are 3 ego states, Parent (Taught), Adult (thought) and Child (felt), if you communicate with someone from the Child ego state the response you will receive is one from a Parent ego state and vice versa, and the most beneficial form of communication is Adult to Adult. In my opinion is that if this is taken in the context of communication (verbal or non) within multi-cultural teams, if a team leader can address all individuals as an Adult, an adult will respond, warranting a productive team or successful project. It is important to note that the different categories of communication are important at this point as only 7% of meaning is in the words spoken, 38% of meaning is paralinguistic (the way that the words are said) and the final 55% is in facial expression or body language. Adding to this the knowledge that cultural differences can be as simple as a smile, an adult response will encourage the individual to participate in the communication and explain rather than be mocked (child) or scolded (Parent). An example of this would be: The day leader of the group (the day leader is an individual from the team who is chosen by the team to be the temporary leader, and usually is in this position for 3 days) had allocated tasks for the group, on day 3 of their day leader duties there was unrest within the group,(this unrest was fueled by the day leader) a team of 4 had been working on one particular part of the project which was digging cess pits for sanitation units, the day leader had allocated herself to this task for the 3 days and was unhappy at the amount of time standing in a muddy hole. Due to her frustration and the teams bickering, she approached the Team Leader and started shouting about the situation (raised voice, arms crossed in front of body, emotive language = Child ego), how it was extremely unfair that they had this task and how disgusting standing in a puddle was. The Team Leader responded in a (calm voice of normal range, arms to the sides creating neutral body language = Adult ego state) and asked questions such as: Is there anything you could do differently to resolve the situation? How can we all ensure this does not happen again? The response from the day leader was instantaneous, the shouting stopped and the day leader re allocated the team to different roles, set up a rotation system with a suitable handover discussion and communicated the change to the entire team. This is an ideal scenario, the change in response was very fast. Sometimes it may take a few interactions from the Adult ego to bring the other individual to reciprocate appropriately. Conclusion This example demonstrates that the reaction of the Team Leader ensured that the â€Å"issue† was resolved. By doing this through questioning and facilitating a conversation, the day leader felt that they were in control of the group, and were empowered to make decisions, then communicate those decisions, better enabling the day leader to perform their role whilst being supported by the team leader. As it can be the first time they have lead a team, add to this cultural differences and language barriers and It can be a very confusing and intimidating time for a day leader, and the Team Leader should expect confrontations like this, When we talk about culture it is useful to understanding it can be broken down in to basic topics, such as why and when someone smiles, and accepting that it may differ from what we already know. This helps the individual to have an open mind and appreciate that everything they know about human behavior in their own environment, can, and should, be challenged, and the results are likely to appear different from what they currently know.