Thursday, January 30, 2020

The Joint Commission Study Essay Example for Free

The Joint Commission Study Essay Executive Summary The Joint Commission is scheduled to visit Nightingale Community Hospital for its triennial accreditation survey within the next 13 months. The purpose of this document is to provide senior leadership with an outline of the hospital’s current compliance status in the Priority Focus Area of Communication. Recommendations for corrective action are included in this document which are designed to bring the organization into full compliance in the areas where deficits have been identified. The Priority Focus Area of Communication includes 3 Joint Commission (JC) standards relative to Universal Protocol. These 3 standards, which are components of the National Patient Safety Goals, are aimed at ensuring the correct procedure is performed on the correct patient at the correct site. UP.01.01.01 requires the organization to conduct a pre-procedure verification process prior to the start of any procedure. The hospital meets this standard by following its policy titled â€Å"Site Identification and Verification (Universal Protocol)† which describes the process that is used prior to the start of any operative or invasive procedure. The hospital’s use of the â€Å"Pre-Procedure Hand-Off† checklist provides the documentation required to demonstrate compliance with the standard. Because of the criticality of this standard, I recommend a focused medical record review to measure compliance with the use of the pre-procedure checklist. If the audit reveals the checklist is completed consistently, full compliance with the standard will be verified and no further action will be required. UP.01.02.01 requires the organization to mark the procedure site before the procedure is performed. The Site Identification and Verification policy describes the process for marking the operative site however the policy as written does not meet the full intent of the standard. The policy states the patient will identify and mark the operative site. Element of Performance 3 of the standard requires the procedure site to be marked by the licensed independent practitioner who is accountable for the procedure and will be present during the procedure. EP 5 requires a written process for patients who refuse site marking or when it is impossible or impractical to mark the site. This written process is absent in the hospital’s policy. Nightingale’s policy and process must be revised immediately to reflect all the required eleme nts of the standard. Hospital physicians and staff must  be educated on the necessary changes and the revised process must be put into action. Once these changes have occurred, I recommend a focused audit to ensure full compliance with the revised policy/process. UP.01.03.01 requires a time-out before the start of the procedure. The Site Identification and Verification policy describes the time-out process however the policy falls short of fully meeting the intent of this standard. EP 2 describes which team members must participate in the timeout, EP 3 requires a time-out before each procedure when two or more procedures are being performed, and EP 5 requires documentation of the time-out. These 3 elements are missing from the hospital policy/process and therefore revisions to the process/policy are necessary to include these 3 elements. Nightingale’s Safety Report reveals increasing compliance (nearing 100%) with the time-out process, however as mentioned above, EP 5 requires documentation of the process. In addition to the policy revision, I recommend the development of a unique form which will be used to document completion of the time-out and the names of the participants in the time-out. Once these changes have been implemented, I recommend additional auditing to ensure full compliance with docum entation of the time-out process. The Joint Commission reports more than 900 Sentinel Events related to wrong site surgery occurred between 1995-2010 (The Joint Commission, 2010) Their research found that 70% of the time, the root cause of wrong site surgery was communication failure (Mulloy and Hughes 2008). When it occurs, wrong site surgery can be devastating for patients and it can leave a lasting, negative impact on the surgical team. Surgeons are at risk of losing their license and hospitals risk losing reimbursement. When these events occur the risk of litigation exists as well. Wrong-site, wrong-procedure and wrong-person surgery can be prevented! The Priority Focus Area of Communication as it relates to Universal Protocol is essential to Nightingale Community Hospital for preventing wrong site surgery and promoting a safe environment within our hospital. The hospital’s Site Identification and Verification policy was developed with good intentions to meet that goal. The 3 key elements to preventing wrong site surgery; 1) pre-op verification process; 2) marking the operative site; and 3) taking a time out, are all present in the policy however there are additional elements required by the Joint Commission that are missing from the policy  and leave the organization and pat ients at risk. In order to live up to our core value of safety and to ensure full accreditation with the Joint Commission, it is important for the organization to fully meet all the elements of performance. The changes outlined within this document will strengthen the policies and procedures that are intended to prevent harm to patients and will bring the organization into full compliance with the JC standards. These actions will ultimately ensure that a truly safe environment exists within the walls of Nightingale Community Hospital for the benefit of its patients, associates and the community. References The Joint Commission. (2010, 11 23). Sentinel event statistics as of September 30, 2010. Retrieved from http://www.jointcommission.org/assets/1/18/Stats_with_all_fields_hidden30September2010_(2).pdf Mulloy, D. F., Hughes, R. G. (2008). Patient safety quality: an evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.nlm.nih.gov/books/NBK2678/

Wednesday, January 22, 2020

Weber Essay -- essays research papers

Max Weber was the first to observe and write on bureaucracies which developed in Germany during the 19th century. He considered them to be efficient, rational and honest, a big improvement over the haphazard administration that they replaced. The German government was better developed than that in the United States and Britain and was nearly equal to that of France. Weber saw that modern officialdom functioned according to six principles: (1) Fixed and official jurisdictional areas which are ordered by rules, that is laws and administrative regulations. (2) Hierarchy and levels of graded authority where the lower offices are supervised by the higher ones. (3) Management is based on official documents (the files). (4) The officials have thorough and expert training. (5) It requires the full time work of the official. (6) Management follows rules. While these principles seem obvious today, German government agencies were pioneering modern administration to replace practices dating back to the Middle Ages owing loyalty to the king, dukes and the church. From the perspective of the official, Weber observed that office holding is a "vocation," that is it is a calling requiring a prescribed course of training for a long period of time and having examinations which are a prerequisite for employment. He is to be loyal to the office he holds, not to a patron. By virtue of his position, the official enjoys high social esteem. (Weber notes that this is especially weak in th...

Tuesday, January 14, 2020

Analysis of the Allegory of the Cave Essay

Plato’s â€Å"Allegory of the Cave† presents a visualization of people who are slaves that have been chained in front of a fire their whole lives. These people observe the shadows of different things shown on the cave wall that is in front of them. The shadows are the only â€Å"reality† the slaves know. This is because they have never seen anything else to compare them to. Plato argues that there is a critical flaw in how people mistake their limited perceptions as reality, as truth, and as what they believe to be what is good. The allegory reveals how the flaw affects our education, our spirituality, and our politics. The flaw that Plato speaks about is how people trust what they see and think it is real. In The Allegory of the Cave, the slaves in the caves know that the shadows, shown on the wall by the fire behind them, are real. If they were to talk to the shadows echoes would make the shadows appear to talk back. To the slaves, as Plato puts it, â€Å"the truth would be literally nothing but the shadows of the images†¦. † The allegory also talks about how a slave is later brought out of the cave, in what Plato refers to as â€Å"the ascent of the soul into the intellectual world. † Once out of the cave, the slaves discover that what they thought was real is not. They learn to understand all of these new images as what is real and what is true. Since the slaves have been in the dark for all their lives, both literally and metaphorically, the light blinds them. Representing knowledge, the light is too brilliant for them to see and comprehend. The slaves must be re-educated. They have to learn that the reflections are truer than shadows and the objects truer than reflections. They must deal with a new reality that does not exist within the cave. Plato says that these people who are brought out of the cave must go back into the cave to educate the other slaves. But the only people who should be allowed back into the cave are the ones who are willing to go back. The people must teach the other slaves about the reality outside of the cave, and what is outside of the slaves’ reality. These are representing the philosophers in the allegory. The capacity to learn exists in the soul. Humans need to use their whole soul to learn, not just use their eyes. The allegory states that, â€Å"†¦the power and capacity of learning exists in the soul already; and that just as the eye was unable to turn from the darkness to light without the whole body, so too the instrument of knowledge can only y the movement of the whole soul be turned from the world of becoming into that of being†¦. † According to Plato, human beings’ misperception about â€Å"reality† also affects the spiritual growth of that person. When the slave makes the ascent out of the cave that they have been in their entire life and sees the sun, they will be reminded of God. Plato wrote about how the slaves may even mistake the sun for God because the slaves would have no real perception of what the sun or what God looks like. Having moved from darkness into light, the slaves come to the conclusion that this bright light must be God. Plato argues that one’s soul holds knowledge of what is true. When one learns, one simply remembers. People originate from Heaven where they knew the truth. In the Bible it even talks about how on the outside people are wasting away every day but on the inside they are being renewed every day. One is renewed day by day by remembering things that their soul knows, but that they have forgotten. Also, Plato discredits a government run by the people in the cave who are uneducated and yet still fight for power. He also argues that the people who have made the ascent from the cave must govern, for they know what is real and what is not real because they understand that the shadows are only dreams, or something that is unreal. Plato says it is difficult to go back down into the darkness after somebody has seen the light, but they must. They must educate the slaves about the world above, so the slaves understand that power is not the greater good. Even though it will be about ten times harder to readjust to the darkness after descending into the cave again they will see about ten times better, because now they know the shadows are not real. They will govern with knowledge of good and truth. I believe that the Allegory of the Cave simply states that we must question reality and we must not trust just what our eyes tell us. We must know more than just what the eyes see. The slave in the allegory that makes the ascent and eventually rejects the truth of the shadows comes to know a truer truth. But then they believe what their eyes show them that is on this world. They have forgotten that they must question reality, because how are they to know that this reality is realer than that of the caves’? Somebody may wonder what if we are the shadows in the cave. And who knows. It corresponds to having an imaginary friend when a person is younger. The imaginary friend is very real to whoever the befriended person is, but as the person gets older or makes the ascent to the world of knowledge, they will mostly likely reject their childhood imaginary friends. Everybody is faced with a different reality where they start to believe that what their eyes show them is the only truth. They forget to question things and don’t realize that maybe there is yet another ascent, out of this bigger â€Å"cave† of the light. It may be something that nobody will know about until they reach the point of ascent. Human beings’ knowledge of goodness, reality, and truth will forever be limited by their fear of new ideas and new perspectives. As long as people are afraid of questioning what they cannot see, they will be stuck, chained up as slaves who are trapped in the darkness of the unknown in their very own cave.

Monday, January 6, 2020

Dumbcane Stem Extract as Rodenticide or Black Rats

Dumb Cane (Dieffenbachia seguine) Stem Extract as a Rodenticide for Black Rats (Rattus rattus) PROPONENTS: Dolino, Alma Gubalane, Delsan Miquiabas, Cheryl Telen, Nikol IV- Einstein Mrs. Lalaine Biboso Research II Adviser ABSTRACT Black rats are pests and are dangerous to humans in several ways. These species are also famous for its role in spreading the dreaded bubonic plague that took billions of lives in the Middle Ages. To control them, chemical rodenticides are used but these chemicals often destroy our environment and health, and may lead to death of non-targeted organisms and even human poisoning. Dumb cane contains calcium oxalate crystals that cause the poisoning. Thus it was the concern of the study to determine whether the†¦show more content†¦Significance of the Study This study will help people get rid of rats that are quiet a nuisance to the householders and even transmit some dreaded diseases. This will also help lessen the use of commercial chemicals used as rodenticides, which destroys our environment and health. Besides, this can also be beneficial because people can minimize their expenses. So, in this simple way, people can save money. Scope and Limitation This study was only limited on the effectiveness of dumb cane stem extract in killing house rats. Its effectiveness was measured by counting the number of rats killed in 2-6 days after they were fed to rats. The dumb cane extracts were mixed with chiffon cake. The actual observation and counting were done at an interval of 2 days. Each treatment was given 3 replications. The commercial product which was the control was Raccumin. Dumb cane stem were taken from the house of one the researchers. This study was conducted at the DOST Laboratory at the barangay hall of Calumpang compound last July 29, 2005. CHAPTER II REVIEW OF RELATED LITERATURE This chapter gives the background and the related information about the study. Dumb Cane Dumb cane (Diffenbachia seguine) is a shrub, and a native to the West Indies. Its common name derived from the fact that if its stem, which contain