Safety Precautions for Nurses while delivering Medications to Patients Essay

Safety Precautions for Nurses while delivering Medications to Patients - Essay Example â€Å"A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use" (National Coordinating Council for Medication Error Reporting and Prevention, 2012, p. 1). From the definitions, these errors are an action that are apparently committed and are divergent from the intended act; and, as a consequence fails to adhere to the principles of safety and conformity to the delivery of the highest quality of patient care, as expected from the health care profession. The Institute of Medicine (IOM) appropriately provided definitions of patient safety and quality of care as presented from the paper written by Mitchell. Accordingly, the IOM was reported to have provided the definition of quality as â€Å"the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge† (Lohr, 1990; cited in Mitchell, 2008, p. 1). As such, quality of care incorporates elements that ensures patient safety and the delivery of highy quality of health services. Concurrently, patient safety was defined by the IOM as â€Å"the prevention of harm to patients† (Aspden, Corrigan, Wolcott, & al., 2004; cited in Mitchell, 2008, p. 2). The nursing theory that espouses both patient safety and quality of care is adherence to the principles of beneficence and least harm: to do good and to possibly inflict the minimum possible harm, if not at all preventable. In this regard, several studies have already tried to

The Impact Of Satisfaction And Image On Loyalty Essay Example for Free

The Impact Of Satisfaction And Image On Loyalty Essay The research was undertaken by three eminent scholars with strong qualifications in the field of customer services and business; two of them having attained the rank of professor and the other a doctor working as a research fellow. Their background suggests that the research was of a high quality and followed the laid down procedures for a doctoral thesis or research paper. It was directed at examining the relationship between image and satisfaction to customer loyalty. Current literature on the subject has been inconclusive on the impact of satisfaction on loyalty without considering the effect of image on the same. This research aimed to fill this void. By addressing the subject matter and testing it using hypotheses, the researchers adopted qualitative and quantitative research methods and were able to come up with a general statement that image impacts loyalty from an emotive rather than a cognitive point of view. Entrepreneurs are concerned at how they can retain their market share and the methods they can adopt to increase the number of clients that patronize their outlets. A lot of emphasis has been placed on the importance of customer service in ensuring repeat clients and new customers (Anderson et al. 1994:54). For the most part it has been true that customers who have been well treated and had all their concerns attended to in a timely manner are likely to return to the establishment for further business. However customer satisfaction has not been able to explain why clientele appear to shift loyalties to new outlets or to competitors despite receiving excellent services (Chi Qu, 2007). This phenomenon suggests that there are other factors that influence customers in making their final decisions on which places to patronize. This research has addressed this issue by studying the effect of image as a predictor of customer loyalty. Abraham Maslow developed his hierarchy of needs theory which posited that man graduates from satisfying the basic needs to the pinnacle of the pyramid where self actualization is achieved. Self actualization has little to do with physical aspects and more to do with personal feelings and perceptions of self. Thus as a pointer to what influences customer loyalty, the researchers picked on a good factor to base their study on. Nonetheless in this era of global recession other factors like price should have been included in their study so as to compare the overall effect of price differentials to customer loyalty. The rise of budget airlines like Easy Jet or the popularity of supermarket chains such as Wall mart are primarily due to the fair prices they charge in comparison to other stores (Fredericks and Salter, 1995:30). Thus in limiting themselves to image and customer satisfactions the researchers left out an important factor that may change the overall results of the study. By confining their study to ski resorts the researchers have narrowed the application of their research findings in that the nature of studies in ski resorts find little relevance to other areas of business. To begin with ski resorts are a feature of areas that experience a certain type of climate and appeal to people who are accustomed to that kind of weather (Matzler et al. , 2007). Those living in warmer climates may patronize tourist attractions not necessarily because of image but because of the available attractions (Bigne? t al. , 2001:609). Some of the most famous tourist destinations in the world do not have excellent facilities but offer the clientele a once in a life time experience such as the wildebeest migration that occurs across the Masai Mara in Kenya (Kenya safari holidays, 2008). Secondly, most customers going to ski resorts do so because they want to ski. This restricts the research applicability to this kind of pastime as opposed to providing a general observation that can be useful to all types of businesses. The researchers made good use of available literature as a starting point to base their study. Most of the material they researched on was from primary sources in journals and a few books. Primary sources are vital in that they provide firsthand information about the subject matter from the author’s perspective. The problem with relying too much on such material is the obvious bias that most authors have in expounding their views. Secondary sources help to balance the overall picture by presenting alternative views and critiques of works done by other researchers. Sample population numbers were high enough to give a truly representative result of the study. With over 6,000 respondents to the online survey, the study was able to capture enough data to satisfy the research needs. The issue of enticing the respondents by offering attractive prizes could raise ethical questions and may have influenced the respondents to respond in a certain fashion. Respondents may have filled out the survey hoping that their responses reflected the expected outcome and thus improved their chances of winning the prizes. In adopting a multi-attribute approach in studying the effects of image on loyalty, the researchers were able to investigate a number of parameters that affect people’s perceptions. Despite the holistic nature of this approach, the use of Likert scale tools to determine the respondents’ views can be misleading as the results are highly subjective with one respondent rating a certain parameter differently from another irrespective of a general consensus on the nature of the service being offered or the factor being tested (Homburg and Giering, 2001:55). The hypotheses postulated by the researchers fail to include the possibility that there could be other more important factors that impact customer loyalty (Mittal and Kamakura, 2001:137). Such aspects include proximity of a resort to the client’s domicile, prices charged by the outlet, complimentary services offered as an incentive, and the nature of the ski terrain that may encourage amateurs or more experienced skiers to patronize the resort (Fakeye and Crompton, 1991:11). A fourth hypothesis should have been included to addresses these issues and could have been structured as follows; H4: Apart from image and loyalty there are other factors that significantly determine customer loyalty. Null hypothesis: Image and loyalty are the only factors that determine customer loyalty Respondents to the survey were not determined by the researchers and as such their study could not have investigated other aspects of the sample population like the differences in loyalty based on ethnic identities or gender. Any results based on the nationalities or gender of the respondents may not correctly reflect the true picture without purposely setting out to research such aspects. The research findings more or less confirmed the researchers’ thesis and added to the available literature on the subject. An interesting outcome was that the influence of image was more of an emotive response than a cognitive one (Kandampully and Suhartanto, 2000:349) This will assist entrepreneurs to develop the emotive image factors like patriotic themes or domestic settings that will make the customers feel that they are quite at home, though away from home (Gallarza et al. , 2001:62). However, the study is incomplete because it fails to address other factors that impact loyalty and it does not investigate the responses by respondents with different backgrounds to establish whether the findings are universal or ethnic specific. By focusing on ski resorts, the study is severely limited in its application as the findings in that industry may not be relevant to other business models or geographical destinations. This research is invaluable as a tool to improve to improve market share and annual incomes for ski resort outlets. By maintaining good customer service and working on developing the emotive image of the establishment, the management is bound to see an increase rise in customer loyalty (Eskildsen et al. , 2004:862). Its findings should be compiled in a simple format for the ski resort operators to understand and apply in their daily operations. The researchers may want to add on a caveat that the image and loyalty are not the only factors responsible for customer loyalty and that further studies may be required to identify other issues that may be influential. In summary, the research has been able to investigate the relationship between image, customer satisfaction and loyalty within the scope of the researchers outline. Despite the research failing to examine all aspects that impact customer loyalty, this should not invalidate their study but rather open up other opportunities for other researchers to take up the challenge to provide such answers. Further studies on the same subject matter should be structured to provide a general theory that will apply to all types of businesses.

Video Games Bring People Together Essay Example for Free

Video Games Bring People Together Essay Ever since the day that I was born I have had some kind of video game console in my house. Having a video game console in my house my entire life has brought many joyful experiences to my life. So I believe that certain video games are able to bring people together. Even though my dad had two years to practice on the console, about one year after I started using the console I was already better than him. This forced him to start playing the game after I had gone to bed so that he would also improve. Many people always say that video games are a huge waste of time. They couldn’t be more wrong. I have realized after reflecting on my life that certain video games have given my some of my best memories. I even think that I am not the only person in the world who has noticed how games have affected their life. A video game also won’t just cause people to have fun together it will forge a special connection between them. The one game that affected me the most was my very first game, Diddy Kong Racing. Diddy Kong Racing is a racing game, if you can’t tell from the title. In the game you travel around into different areas trying to unlock keys, by winning races of course, that will allow you to progress. Diddy Kong Racing was my very first game that I had ever played and my dad was always trying to teach me how to play. This game also brought many fun and competitive experiences with my dad and my mom on certain occasions. The most memorable experience with this game was on a four hour trip from Washington D.C. to New York. My mom’s car was able to have a video game console installed in it and the car also included a video screen. So throughout the entire road trip my dad and I sat in the back of my mom’s car playing Diddy Kong Racing. I know four hours seems like a long time but as the saying goes â€Å"time flies when you are having fun.† These four hours was probably the best bonding experience I had with my dad. Video games have showed me that they don’t cause people to become anti-social but that it causes the exact opposite. If used in the right way video games could be used to bring people from across the world together and maybe even change it.

Human Lymphocytes Exposed to Co Irradiations and I Decays

Human Lymphocytes Exposed to Co Irradiations and I Decays Chapter 1: Introduction 1.1. Microdosimetry Problem statement Nuclear medicine and molecular imaging use unsealed radionuclides for diagnostic or therapeutic purposes. In targeted radiotherapy, the aim is to address tumor cells using suitable radiopharmaceuticals and achieve a high dose deposition inside the target structures. â€Å"Macrodosimetry† generally entails estimating the dose effect in organs (or dimensions of at least some millimeters) and is outlined in detail by the Medical Internal Dose (MIRD) Committee, the U.S. Society of Nuclear Medicine and the International Commission of Radiological Protection (ICRP) [1]. Microdosimetry therefore entails estimating the dose absorbed in microscopic objects such as cells. Dose deposition in cells can originate from extracellular media, intracellular uptake in a single cell and from surrounding cells. As an alternative to characteristic photon emissions,radionuclides decaying by electron capture or internal conversionmay undergo a process known as the Auger effect. In the Auger effect, an electron from an outer shell fills the lower electron vacancy, but the energy released in the process is transferred to another orbital electron. This electron is then emitted from the atom instead of a characteristic X-ray [2]. The emitted electron is called an Auger electron,with ranges in tissue typically at the micro- or nanometer level [3].Their unique property of depositing significant amounts of energy in minute volumes around the decay site opens up the possibility of using them as microscopic probes to study fundamental questions regarding the interaction of radiation with cells. 123I is used mainly in nuclear medicine because of its ideal ÃŽ ³-ray energy (159 keV) and relatively short half-life (13.2 h). The decay of 123I is, however, also associated with the production of Auger electrons. These low energy particles (4]. Knowledge of the absorbed dose is required for evaluation of the observed biological effects and to predict or compare the effectiveness of different radiation modalities. However, direct dose measurements in cells are impossible due to the small cellular dimensions [5]. According to the stochastic character of all of the decay processes, a large number of pathways exist by means of which a radioactive particle can decay and the excited atom can de-excite, i.e. each initial inner shell vacancy may cause a different number of Auger electrons to be emitted resulting in a more or less broad distribution of differently charged ions. Because these electron transitions and particle interactions are random processes, the Monte Carlo technique is an appropriate tool for the simulation of Auger emissions and electron spectra, as well as a feasible method to obtain correct absorbed dose values under consideration of all irradiation aspects like geometry and activity distributions [5],[6], [7]. Bingham et al. found that the dose delivered to the cell nucleus is underestimated by a factor of 7.4 for 123I in cells with nuclear radius of 4 ÃŽ ¼m and cell radius of 12 ÃŽ ¼m when compared to conventional electron dosimetry, indicating the need of developing dosimetr ic calculations for electrons emission at a cellular level [8]. Geant4 is an open source Monte Carlo (MC) toolkit, based on object orientated programming rules using the C++ language, which provides functions for simulating the passage of particles through matter [9]. The code is freely downloadable from the Geant4 web site. Detailed descriptions of the toolkit design and the physical fundamentals may be found in the â€Å"Geant4 User’s Guide for Application Developers† and the â€Å"Physics Reference Manual† [10], [11]. Besides the fact that it is entirely open-source and freely available to all users, the main advantage of this toolkit is its openness to modification and extensions. Originally Geant4 comes from high-energy physics but it also provides low-energy physics processes necessary for medical applications. Users may construct stand-alone applications or applications built upon another object-oriented framework. In either case the toolkit offers support from the initial problem definition to the production of results and graphics for publication. At the heart of Geant4 is an abundant set of physics models to handle the interactions of particles with matter across a very wide energy range. Data and expertise have been drawn from many sources around the world,and in this respect Geant4 acts as a repository which incorporates a large part of all that is known about particle interactions[12]. All aspects of the simulation process have been included in the toolkit: the geometry of the system, the materials involved,the fundamental particles of interest, the generation of primary events, the tracking of particles through materials and electromagnetic fields, t he physics processes governing particle interactions, the response of sensitive detector components, the generation of event data,the storage of events and tracks, the visualization of the detector and particle trajectories, and the capture and analysis of simulation data at different levels of detail and refinement. 1.2. Objectives Aims The level of biological effects of certain radiations is not always directly proportional to the dose they impart. Since the delivered dose on a cellular level is not directly measurable using current instrumentation, scientists and physicians have developed correlations between the biological response and the exposed dose through experiment and theory of atomic physics. An alternative method of predicting the delivered dose in a cell is by using Monte Carlo simulations. These simulations however, have to describe the biological composition and geometries of the material as accurately as possible, as well as the interactions of different particles with the material and can therefore result in complex codes and extremely long computation times. In our study, the aim was to determine (through experiments and using Monte Carlo simulations) the relative biological effectiveness[1] (RBE) of isolated and stimulated human lymphocytes exposed to 60Co irradiations and 123I decays. The first phase of experiments was the exposure of 3 different types of cellsto a 60Co-teletherapy unit. The proposed cell lines were: human lymphocytes, rat brain endothelial cells(bEND5, a cell with high radiosensitivity) andChinese hamster ovarian cells (CHO-K1, a cell with low radiosensitivity). The cells were exposed to graded doses of 60Co ÃŽ ³-radiation, after which they were cultured and the micronuclei formations in binucleated cells were used to analyze the effects of ÃŽ ³-radiation on the cell types. The second phase of experiments was the exposure of a known number of isolated and stimulatedhuman lymphocytes to certain activities of 123I for a discrete amount of time. The thymidine analogue 5-[123I]-iodo-2-deoxyuridine (123IUdR) was prepared and used to incorporate123I into theDNA of human lymphocytes. This was done such that the radionuclide could be transported across the cell and nuclear membrane to permit the deposition of Auger and Coster-Kronigelectrons in close proximity to cellular DNA. After exposure, the samples werecultured to express residual radiation damage. The cellular damage was quantified by numerating the micronuclei (MNi) frequency in binucleated (BN) cells.The experiments were done at iThemba LABS under the supervision and guidance of Prof. Slabbert and Philip Beukes. The experimental work followed the same approach as that of Slabbert, et al[13]. In the study they focused on the targeting and accumulation of 123I in human lymphocytes and CHO-K1 (a Chinese hamster ovary cell line). They found that the combined effect of intracellular and extracellular disintegrations of 123I is about 3.7 times more potent to lymphocytes compared to when the disintegration of the radionuclide is restricted to only the extracellular medium, among other results. It was concluded that this enhancement is due to the short range Auger electrons emitted by the isotope. Next, we wished to recreate the above experiments through Monte Carlo simulations and thereby determine as accurately as possible the absorbed energy and dose due to the irradiations,specifically the energy and dose deposited by Auger electrons produced during the decay of 123I. We will make use of a Monte Carlo based simulation code Geant4. The code must be mastered and used to simulate the scenarios mentioned above. We attempted to simulate the above 60Co exposures. This simulation was an investigation into the irradiation of a macroscopic volume by a radioactive source. The geometry was set up to replicate the experimental setup with regards to the source location and type, collimation, build-up and backscatter, the Petri dish and cellular media. The individual cells were not used as detectors, only the effective volume in the Petri dish. The energy and the dose deposited by the 60Co source (ÃŽ ³-rays, primary and secondary electrons) was then quantified by the Monte Carlo simulation. Our main endeavor was to simulate the energy deposition from the decay of 123I within a cell using Geant4. Basically, a geometry representing a biologicalcell (with the same density, etc. as the proposed lymphocytes) was created as a detector to measure the dose, energy and particles traversing it due to a radionuclide prone to emit Auger electrons, i.e. 123I. A similar simulation was performed by Bousis, et al (2012), using their in-house Monte Carlo code [14]. More advanced simulations are the calculation of DNA strand breaks due to direct and indirect effects of Auger electrons as was demonstrated by Raisali, et al (2013), which werehowever not attempted in this investigation [15], [16], [17]. Furthermore, an empirical formula relating the activity(and consequently the absorbed dose) to the biological response was determined. The curveswere compared to other dose-response curves from literature, thereby indicating if the simulations are a viable option for predicting accurate dose depositions. We could then calculate the RBE values from our dose-response curves and compare them to values available in literature. Finally, we aimed to determine the accuracy and feasibility of Geant4 as a simulation toolkit for medical and radiobiological purposes. To this end we considered the practicality, effort and time spent using Geant4, as well as by the comparison of RBE values and dose-response curves. Geant4 is an advanced, extensive and comprehensive simulation toolkit. Its advantage over similar packages with regards to availability, artistic and geometric freedom, physics models and materials libraries and openness to modification are undeniable. It is a very powerful simulation toolkit and can be used in a large number of areas of expertise as is shown by the examples supplied alongside the toolkit. [1]RBE values indicate the effectiveness of two radiation qualities to produce a certain biological response.

Speak Essays -- essays research papers

Speak, by Laurie Halse Anderson, is first-person narrative about overcoming our habits and misfortunes. It takes place at Merryweather High over the course of a year. The main character, Melinda, is a fourteen year-old, who is just starting high school. She is introduced, at first, as someone who doesn’t speak to anyone, almost, at all. All the other people in the high school seem to detest her. They say hateful things to her and throw objects at her. She seems not bothered by any of this. She is in her own being.   Ã‚  Ã‚  Ã‚  Ã‚  As the story progresses clues to why people hate her so much are revealed. There is mentioning of a party that Melinda, some how, ruined. People say that they or someone they knew got in trouble at the party. Melinda wants to forget that party. She blocks it out of her head. At every mention of that night Melinda cringes.   Ã‚  Ã‚  Ã‚  Ã‚  Melinda doesn’t like school. She hates the people and despises the classes. All of the classes except art. She loves her art class. Their assignment for the year is to create a piece of art, depicting a given image, that makes a statement. Melinda’s object is a tree. She has trouble with the tree.   Ã‚  Ã‚  Ã‚  Ã‚  Melinda starts school off in a bad way. She continuously gets in trouble with numerous teachers. She never does any homework. She mostly takes naps. Worst of all, in her mind, she has no friends. This does not change until she meets Heather, the new girl. Heather is...

Maxine Hong Kingstons Woman Warrior - No Name Woman Essay -- Woman Wa

Maxine Hong Kingston's Woman Warrior - No Name Woman The excerpt, "No Name Woman", from Maxine Hong Kingston's book, Woman Warrior, gives insight into her life as a Chinese girl raised in America through a tragic story of her aunt's life, a young woman raised in a village in China in the early 1900s. The story shows the consequences beliefs, taught by parents, have on a child's life. Kingston attempts to figure out what role the teachings of her parents should have on her life, a similar attempt for many of us in the world. Lessons taught by our parents, the people who brought us into this world, help guide us into the people we become as adults. Hopefully, the guidance is positive. Kingston's story about her aunt sends a message as to how many families communicate the meaning of life. Through this story you will see how much we truly learn from our parents, some of it good and some of it bad. The story of Kingston's aunt, as told by her mother, started out by her mother saying. You must not tell anyone," my mother said, "what I am about to tell you. In China your father had a sister who killed herself. She jumped into the family well. We say that your father has all brothers because it is as if she had never been born." (Kingston, 319) In the first sentence of this quote, the mother is asking her daughter, Kingston, to remain quiet about a negative event, an occurrence deemed as shameful, in the family's life. Kingston's mother, playing a role model, taught her daught...

The Canadian Governing System is not Fair or Democratic Essay -- essay

There are Canadian citizens who thought that the Canadian government we have is perfect, citizens who believed that every aspect of the government was truly democratic, and citizens who believe that government could do no wrong. Truly this group of believers has been living a lie. In our Canadian system of government, large aspects within are far from democratic and need to be changed. Liberal-minded people will cry out for a change in order for government to serve the people better, and on the other hand the more conservative thinkers will argue that no change is needed because our government is efficient and considerate. However, our voting system, our Senate, and the power vested to the Prime Minister are far from democratic, do not meet the actual needs of the people and definitely need to be addressed. Canada itself claims to be democratic, yet the Canadian Senate is appointed to office by the current Prime Minister rather than elected by the citizens. The original purpose of the Senate was to give fair representation between provinces and to the citizens. Having failed its purpose, clearly there are issues within the Senate that need to be addressed. Because of the Prime Minister appointing the Senators, they will now serve the Prime Ministers needs rather than the people who they should have been listening to. As if this were not enough of a show of power for the Prime Minister, the Senators cannot be lawfully kicked out of office until the age of seventy-five. An example of Senate idiosyncrasy in Canadian government is Ross Fitzpatrick, who was appointed to office by former Prime Minister Jean Chretien of the Liberals in June 1990. His official opponent, Preston Manning, rightfully questioned the circumstances regardin... ...e a lot of parties are going to be running for office. However, for the fringe parties this creates a major advantage for them. With the load of political parties in the House of Commons, there would be a wider range of interests for people but there would be a lot of indecision and coalitions. It is cold hard fact that Canadian government is not entirely democratic. The question remains of how to deal with this. Canadian government, as effective as it currently is, has major factors in their system that have a negative effect on Canadians. Our current voting system favors the higher-populated provinces and creates a tyranny of the majority. Our Senate is distinctly undemocratic as it is an assigned position. Our head of State, the Prime Minister, holds too much power. Unless we resolve these issues, our government will remain far from a perfect governing system.