How Technology Has Changed the World Essay Example for Free

How Technology Has Changed the World Essay The world has surely changes a lot in just a few years. The life people are living right now is way different than the life people used to live some years back. And if theres something responsible for this change, its technology. Technology has surely changed the world. It has also changed or thoughts about gadgets and other technological stuffs. Technology is that one thing that has been evolving each and every day making life of people simpler and easier. Technology is something that everyone is fond of. Doesnt mater if its a 5 year old boy or a 60 year old man,. everyone is interested int technology Technology has changed the way we look at out lives. Technology has brought a drastic change in your life. In our parents time, the term Luxury referred to Gold, Silver, acres of land they owned. But now, the most luxurious products are Gadgets or technological innovations. Technology has become everything for people. You want to decorate your house, you go for a big 65 led TV. You love music, you go and get a 5.1 Woofer which gives enough bass to shake the whole building. What you have describes your class. Anyone today wants to stay updated. No matter who you are, you will need to know about technology if you dont want to be called a fool. Technology has inspired a lot of us including me. So, let us all stay updated and know about gadgets. Read more:Â  How Technology Changed Our Lives

Analysis Of Britannia Industries Limited Marketing Essay

Analysis Of Britannia Industries Limited Marketing Essay An Analysis On The External Factors Affecting The Company And The Role And Importance Of Stakeholders Britannia Industries Limited (BIL), formerly known as Britannia, was established in the year 1892. Britannias business was flourishing. In 1910, Britannia mechanized its operations, and in 1921, it became the first company east of the Suez Canal to use gas ovens. In 1979 it was renamed to Britannia Industries Limited, with an Indian shareholding of more than 60%. After few years, in 1997, Britannia made its debut in the dairy products market. Britannia is not only known for the quality of its products but also for the innovative approach towards them and the marketing. In 2002, Britannias New Business Division formed a joint venture with Fonterra, the worlds second largest Dairy Company, and Britannia New Zealand Foods Pvt. Ltd. was born. Britannia was rated One amongst the Top 200 Small Companies in the World (200 Companies for 2002 (2002) Forbes.com) and was awarded The Economic Times as The Second Most Indias Trusted Brands (Dettol is most trusted brand (2002) The Times of India ). Britannias market is not only limited to India but also extends to few countries in Middle East, Seychelles, Singapore, Ghana and USA. Today, the company is operations extend from manufacturing bakery products like biscuits and breads to the production of dairy products like cheese and butter. Aim of the Report To analyse the macro and micro external environment with the help of tools like PESTEL and Porters Five Forces respectively. To role of stakeholders and the importance of stakeholders in influencing the strategies with reference to Corporate Social Responsibilities. Macro External Environment Analysis Macro external environment here includes the factors such as issues related to politics, economical reforms and achievements, social behaviour, technological enhancements and inventions, environmental changes and environmental concerns and legislation and legislative changes. All these factors bear a significant effect on any industry and business. A business has take into consideration all such effects and then formulate its strategies and policies to work along with them and prosper. PESTEL analysis tool helps in determining the effect of all such factors on an industry and businesses. With the help of PESTEL analysis we will be seeing the affects of such factors on Indian Bakery and Dairy Industry. PESTEL analysis is a technique for identifying and listing the political, economic, social, technological, environmental and legal factors in the general environment most relevant to an organisation. (Boddy, D (2005). Management An Intoduction. 3rd ed. UK: Pearson Education. 88.) Type of Factors Effecting Factors Political Economical Social Technological Environmental Exemption on Customs on Sugar Raw Material Import Shortage of Milk Need for Healthy Eating Habits Cloning of Livestock Change in the Climatic Conditions VAT on Biscuits Rise in Sugar Production and Duty Free Sugar Imports Problems with Cloned Livestock New Age Packaging Removal of Import Duty on Dairy Products Globalization Incentives to Build Cold Storage Facilities Requirement for Logistics Political Exemption on Customs Duty on Sugar Raw Material Import Due to the shortage in the production of sugar the deadline for the exemption on customs duty on raw sugar imports has been extended by the government to April 1, 2011 (Dey, A Jha, Dilip K (2010) Duty-free sugar imports extended till April 2011, Business Standard). Since sugar is a major input in the bakery, the price of sugar highly influences the price of inputs of the bakery industry. Exemption on customs duty will help in purchasing sugar at lower cost, which in turn will control the cost of production. VAT on Biscuits The VAT of 12.5% on Biscuits, being the only processed food item to attract such high VAT rates, will affect the pricing of the product (Bhushan, R (2009) Biscuit prices to rise by 10%, The Economic Times). Price of the biscuits might need to be increased due to the high VAT rates which may result in switch of brands due to the highly competitive market. Removal of Import Duty on Dairy Products The whole-sale price based inflation indicates that the milk prices have moved up by 14.73% over the last year. Worried about the rising prices government announced the removal of duty on Skimmed Milk Powder (SMP) and other dairy products (Govt removes import duty on dairy products (2010), Business Standard). The imports at cheaper rate would help in reduce the cost factor for dairy products. Incentives to Build Cold Storage Facilities Wastage of food items due to lack of cold storage facilities lead to a loss of Rs. 500 billion every year. The government announces schemes and incentives to attract investments in cold storage warehousing (Union Budget 2010: Cold-storage incentives to attract fresh funds (2010), The Economic Times). Increase in the number of cold storage facilities would help in preserving products better and reduce the wastage cost. Economical Shortage of Milk Even though the milk production has risen by 4.6% compound annual average growth rate, it still cannot match up with the increasing demand. The demand for milk has been growing at a faster rate than the growth rate of milk production resulting in the shortage of milk supply (Milk output would stagnate (2010) The Economic Times).   India cannot meet its expected demand if the demand and supply rise at the same rate. For the same the reason, the milk prices are on a constant rise. Price of milk increased by 12.6% to 13.6% (Goyal, K (2010) Indias Food-Price Inflation Holds Near 11-Year High- Business Week). This can cause an increase in the input cost for the dairy products and which in turn can lead to hike in price or lower profit margins. If the company increases the price of its products, it may affect the sales as it might lose on consumers. Rise in Sugar Production and Duty Free Sugar Imports The total sugar production in the first six months ending September 2010 is expected to be 22% more than the output in the unchanged phase last season, the total production expected is at 16.7 million (Press Trust India (PTI) (2010) Sugar output rises 22% in first half of 2009-10, Business Standard). Due to the shortage in the production of sugar the deadline for the exemption on customs duty on raw sugar imports has been extended by the government to April 1, 2011 (Dey, A Jha, Dilip K (2010) Duty-free sugar imports extended till April 2011, Business Standard). The increase in sugar production and the duty exemption on raw sugar can help in purchasing sugar at lower prices and this in turn can help in producing goods at lower prices. Globalization Globalization a universal phenomenon is affecting each and every industry. The world is coming closer, the communication gap is closing and the businesses are going global. This can serve as an opportunity to expand the business to a global level but on the other hand there is a threat of new entrants from international market. Requirements for Logistics Logistics in India suffer due to the poor infrastructure and other limitations. There is a high demand for sophisticated third party logistics so the domestic logistics service providers are trying to improve their service. International participation is also expected in the logistics industry (Pandey, S Basu, A (2010) Logistics cos ramp up supply chain to meet rising demand, The Economic Times). Sophiscticated logistics system will help in proper supply chain management and on time delivery of goods, which help in maintaining the shelf life of goods on meeting the demand on time. Social Need for Healthy Eating Habits Studies say that Indians are more prone to Coronary Artery Disease (CAD), which is the major independent risk factor causing Cardiovascular diseases, due to the smaller calibred arteries found in Indians (Isalkar, U (2009) Indians more prone to heart disease, The Times of India). This suggests that Indians should move towards more healthy food and diet. This could be a new area to explore for Britannia with its new health associated products like Nuti-Choice biscuits and Actimind flavoured milk. Problems with Cloned Livestock Cloned animals are supposed to be suffering from large-offspring syndrome. The mother cows face a problem in giving birth to the cloned animals as they are larger than normal. Also these cloned animals suffer from health issues (Gogoi, P (2007) The case against cloning, BusinessWeek). It is morally wrong to clone animals as they cause problems to the mother during the birth and moreover the cloned livestock suffer from health issues which might make unsafe to consume the produce from them. Technological Cloning of Livestock India, a late entrant in cloning research, is now moving with a great pace in cloning technology. Hand guided cloning technique, a technique very different from the conservative cloning practice has been a successful venture (Mahalakshmi, BV Chowdhary, S (2009) Cloning Glory, The Financial Express). New Age Packaging The new packaging systems help in protecting food from micro-organisms by creating shelter layer. It uses new technologies like oxygen scavenging function, atmosphere control, biodegrability etc. and is low cost (Han, J Packaging Innovations, Bakers Journal). The packaging technology helps in preserving food for longer by protecting them from micro-organisms with the help of new technologies, thus resulting in longer shelf life of the food. The advantage of low cost packing and longer shelf life could be very beneficial for the company in increasing its profit margin. Environmental Change in the Climatic Conditions Climate plays an important role in the agriculture process. The change in the rainfall pattern has been a matter of concern now in India. The agriculture sector in areas which are monsoon dependent suffered badly due to the change in the rainfall pattern. The sector suffered a huge loss in terms of total output (Bhosale, J (2009) Farmers worried over climate disturbances, The Economic Times). The loss in crop will affect the input supply and this might delay or cause problems in the production. So the industry might not be able to meet the demands resulting in the loss of customers. Legal Raising the Norms for the Probiotic Food There is a need for setting the standards for probiotic food. Clinical tests should be conducted on the probiotic foods before they could reach the market for sale. The Indian Council of Medical and Research has submitted the proposal for the same to the government (Das, S (2009) Probiotic food likely to come under clinical trial ambit, The Financial Express).  Strict norms will help in raising the quality standards but on the other hand the cost and time of production might subsequently increase. Micro External Environment Analysis Factors that influence the micro external environment are Competitor Rivalry, Threat of New Entrants, Threat of Substitutes, Buyers Power and Suppliers Power. These factors play a vital role in determining the current situation of the business and to plan strategies accordingly. With the help Porters Five Forces we will be analysing these factors and their immediate effect on the company. Five forces analysis is a technique for identifying and listing those aspects of the five forces most relevant to the profitability of an organisation at that time. (Boddy, D (2005). Management An Intoduction. 3rd ed. UK: Pearson Education. 83.) Competitor Rivalry: BIL has a market share of 38% and has been growing at 27%, compared to the industry growth rate of 20% (Saxena, R (2007) Battle-scarred Britannia on expansion spree, Business Standard) and has many competitors based on the nature of product. Parle and ITC (Sunfeast) pose a great competition to BIL (Biscuit Industry: India (2010), Market Research India). BIL earning major of its income from the biscuits (Britannia Annual Report 2007-08 (2008)), and Parle and ITC are the other major players in biscuit market. BIL is also into the production of dairy products, where the two major players in market are Amul and Nestle. Amul is the leader in the dairy industry. There is also a high level of competition from the unorganised baking sector. Overall rivalry is high. Threat of New Entrants: The entry on a small scale dairy industry and in the unorganised baking sector is easy. But on the other hand to enter the large scale dairy industry and organised baking sector a huge amount of investment is required in terms acquiring assets and to establish supply and distribution chains. Government regulations pertaining to food norms and others may also seem to be unattractive. Looking at the latest trends, the bakery industry is expected to earn huge revenues which might attract new entrants (Vijay, N (2008) Indian Bakery sector foresees high growth and increasing interest in product offering, FnBNews.com). So the threat of new entrants is moderate. Threat of Substitutes: Savoury snacks, crisps, cereals, fruits and other fast food can be substituted for biscuits. Dairy products are dubious to be replacing with other products as they key ingredients of majority of peoples diet. So the threat is a very moderate threat of substitutes. Buyers Power: The buyers of these products could be a retailer or the consumer. Both the dairy and bakery industry are price sensitive, so a little increase in price might lead the consumer to shift other brand or product. So the buyers power is calculated to be very strong. Suppliers Power: The major supplies for a bakery industry include wheat, sugar and other agriculture products. And the major supplies for dairy products are milk. Its difficult to bargain with the suppliers of the above mentioned inputs as the price of these inputs is majorly influenced by the production of these inputs. The prices tend to be high as the demand for these products is rising at much faster rate than supply. The secondary supplies include the packaging material. The secondary supplies can be easily substituted with the low-cost ones to save on cost. Overall the suppliers power is assessed to be moderate. Conclusion of Five Forces Analysis: There is an existence of major players in the market with a moderate level of threat of new entrants and substitutes. The suppliers power is moderate but the buyers power is measured to be strong. So the rivalry is suggested to be high. Stakeholders and Corporate Social Responsibilities (CSR) Freedman (1984) defines a stakeholder as any individual or group who can affect, or is affected by, the achievement of the organisations objectives. Further in addition to that, Clarkson (1995), stated that the government and the other communities that effect the working of the business and the market also form as a part of stakeholders. Stakeholders, except the employees, have a high power over the strategic change ideas (Hayes, J (2007). The Theory and Practice of Change Management. 2nd ed. UK: Palgrave Macmillan. 153). Internal Stakeholders The internal stakeholders are the ones associated with the company internally. For BIL its internal stakeholders would be: The Shareholders The Board of Directors, and The Employees Currently, nearly 51% of shares are held by Corporate Bodies and the rest 49% is held by the public (Statement showing shareholding pattern (2009), Britannia Industries Limited). The board consists of 11 members (Company Overview, Britannia Industries Limited) and employees nearly 2000 people (Britannia Industries Ltd. Overview, MarketLine). External Stakeholders The external stakeholders are the ones who are not immediately associated with company but influence the decision making of the company. To BIL the external stakeholders are as follows: Customers Suppliers Contractors Government Regulatory Agenices (like Food Safety and Standards Authority of India, etc.), and Society Britannia being the leader in the baker industry of India has a huge amount of customers to cater. Britannia has to keep up the tastes and quality preferences of its customers. The government plays an important in influencing the market by creating and changing the policies. BIL has to adhere to the rules and regulations formulated by the regulatory agencies. The suppliers and contractors form an important part of a business. Britannia completely relies on its suppliers and contractors for its raw materials. Corporate Social Responsibility (CSR) For years corporate entities followed the practice of providing goods and services and maximizing wealth. But the trends have changed over the period of years. The companies are now expected to be more socially responsible. The company now has to be responsible to the stakeholders, society and environment. They are expected to pay back to the environment and society for all the affects that are caused due to its operations (Idowu, S Filho, W (2009) Global Practices of Corporate Social Responsibility. Berlin: Springer. 1-2). BIL believes in working with the society and the culture. It gives a premier importance to the nation and its policies. It believes in being a good corporate citizen by not just adhering to the rules and regulations but also by helping the community to improve the quality of life. BIL involves itself in initiating and providing support to community health and family welfare, water management, vocational training, educating people and encouraging the application of modern techniques and technologies. BIL believes in ethical behaviour (Code of Conduct, Britannia Industries Limited). BIL is taking steps toward conserving the environment by employing new process and upgrading the technology. It is trying to reduce its carbon footprints by recycling the waste heat. It has now filed for carbon reduction benefits (Britannia Annual Report 2007-08 (2008)). BIL has taken steps towards helping the society by joining the nutrition program with Global Alliance for Improved Nutrition (GAIN) and the Nandi Foundation. Along with these organisations BIL will is providing mid-day meals in schools and provide nutrition to the deprived (Britannia Annual Report 2007-08 (2008)).

Laminar Air-flow to Control Operating Room Infection

Laminar Air-flow to Control Operating Room Infection INTRODUCTION Surgical site infections (SSIs) are defined as infections occurring within 30 days after surgical operation or within one year if an implant is left in place and affecting either the incision or deep tissue at the operation site (Owens and Stoessel 2008). SSIs are reported as the major cause of high morbidity and mortality among post -operative patients (Weigelt et.al. 2010). According to UK National Joint Registry Report, during 2003 -2006 period infection was responsible for about 19 % failure of joint surgery resulting in revision procedures (Sandiford and skinner 2009). Micro-organisms in the air particles settle on the wound, dressings and surgical instruments and cause infections (Chow and Yang 2005). Whyte et.al (1982) identified that contamination from patients skin as the cause of infection in 2% cases and from theatre personnel in 98% cases. They also found that in 30% cases, contaminants reach the wound from theatre personnel via air and in 70% cases it is via hands. Generally air quality in the operating room is maintained ventilation system. Additional improvements can be achieved by laminar air-flow system or UV lights. Laminar air-flow system is expensive and require continues maintenance. Its installation increases building cost and the operational cost (Cacciariet.al., 2004: Hansen, 2005). Studies conducted to evaluate the effectiveness of laminar flow produced mixed results and there is no consensus on its role in infection control (Sandiford 2007). In this setting, this paper reviews the recent studies to examine the effectiveness of laminar air-flow in reducing SSIs. Studies for this review were found by searching on databases such as CINAHL, PubMed, Science Direct, Ovidsp, Science Citation Index (ISI) and Google scholar. Keywords used for this search are laminar air flow, surgical site infection, operating room air quality, airborne infections + operating theatre, LMA + infection control. As laminar air-flow is used mainly in orthopaedic theatres, majority of the studies are on joint surgery. OPERATING THEATRE AIR QUALITY AND INFECTION CONTROL Indoor air in an operating theatre contains dust which consists of substances released from disinfectant and sterilizers, respiratory droplets, insect parts smoke released from cautry. Dust particles act as a carrier for transporting microorganisms laden particles and can settle on surgical wound and there by cause infection (Neil 2005). Air particles are found to be responsible for about 80% 90% of microbial contamination (CDC 2005). Modern operating theatres are generally equipped with conventional ventilation system in which filters can remove airborne particles of size >5mm about 80-95% (Dharan 2002). The efficacy of operating room ventilation is measured by the colony forming units (CFU) of organisms present per cubic meter. The conventional ventilation (Plenum) with 20 air exchanges is considered efficient if it achieves the colony count of 35cfu/m3 or less (Bannister 2002). Ventilation system with laminar air-flow directs the air-flow in one direction and sweeps the air particle over the wound site to the exits (CDC 2003). Laminar air-flow with HEPA (High Efficiency Particulate Arrestment) filters system has the capacity to remove air particles of size 0.3  µm up to 99.9 % and can produce 300 air exchanges per hour in ultraclean orthopaedic theatres. (Sandiford and skinner 2009). Laminar air-flow units are generally two types; ceiling-mounted (vertical flow) or wall-mounted (horizontal flow). There are inconveniences associated with both types. Generally the major problem associated with laminar air-flow is flow disruption. With vertical laminar flow, it is the heat generated by surgical lamps creates air turbulence while with horizontal laminar flow it is the surgical team that disrupt the air-flow (Dharan 2002). LAMINAR AIR FLOW IN INFECTION CONTROLL Laminar air-flow system is mainly used in implant surgeries where even a small number of microorganisms can cause infection. In joint replacement surgeries, one of the main causes of early (within 3 months) and delayed (within 18 months to 2 years) deep prosthetic infections was found colonisation during surgery (Knobben 2006). Laminar air flow is supposed to minimize contamination by mobilizing uniform and large volume of clean air to the surgical area and Contaminants are flushed out instantly (Chow and Yang, 2004). Some studies found that this method is effective in reducing infection but some others produced contradicting results (give some reference) A recent study conducted by Kakwani et.al. (2007) found that laminar air-flow system is effective in reducing the reoperation rate in Austin-Moore hemiarthroplasty. Their study compared the reoperation rate between theatres with laminar air-flow and theatres without laminar air-flow system. A cohort of 435 patients who had Austin-Moore hemiarthroplasties at Good Hope Hospital in Birmingham between August 2000 and July 2004 were selected for this study. Of those 435 patients, 212 had operation in laminar air-flow theatres and 223 had operation in non-laminar air-flow theatres. Data were collected by reviewing case notes and radiographs. For all cases antibiotics were administrated and water impervious surgical gowns and drapes were used. In the non-laminar air-flow group it was found that the re-operation rate for all indication in the first year after hemiarthroplasties was 5.8 % (13/223), while in the laminar air-flow group it was 1.4% (3/212). Analysis found that there were no stat istically significant relation between re-operation rate and water impervious gown and drapes (p=0.15), while use of laminar air-flow found a statistically significant drop (p=0.0285) in re-operation rate within the first year after hemiarthroplasties. They found that re-operation rate in no-laminar air-flow theatres were four times greater than that in laminar airflow theatres. Even though the aim of the study was clearly described there was no review of existing studies to identify the gap in the research. Study methods and details of statistical analysis were given elaborately. The sample size seems sufficient. Results were summarized and presented using graphs and charts. Discussion of results was short and seems not adequate to address the objectives of the study. There was no attempt to explain the casual relationship. For example researches were making statements such as à ¢Ã¢â€š ¬Ã‚ ¦the introduction of water-impervious drapes and gowns did not seem to make a statistically significant improvement in the resultà ¢Ã¢â€š ¬Ã‚ ¦. (p.823). Researchers failed to acknowledge any limitations of the study. Data for this study was collected by reviewing patients records. Patients records are considers as confidential and researchers didnt mention whether they received consent from the patients or ethical approval form institution to conduct the study. This ca n be considered as an ethical flaw of this study. There are studies which found that laminar air-flow system is not effective in reducing infection rate. In their study Brandt C et.al (2008) found that infection rate was substantially high in theatres with laminar air-flow system. This was a retrospective cohort-study based on routine surveillance data from German national nosocomial infections surveillance system (KISS). Hospitals which had performed at least 100 operations between the years 2000 and 2004 were selected for this study. Type of ventilation technology installed in operation rooms of selected hospitals were collected separately through questionnaire from infection control teams in the participating hospitals. Surgical departments were grouped into categories according to the type of ventilation system installed. Departments using artificial operating room (OR) ventilation with either turbulent or laminar airflow was included in this study. Total 63 surgical departments from 55 hospitals were included in this study. Analysis was performed to the data set created by merging the questionnaire data on OR ventilation and surveillance data from the KISS data base. The data set analysed contained 99230 operations with 1901 SSIs. Age and gender of the patient was found a significant risk factor of SSI in most procedures. Univariate analysis conducted found that rate of SSIs was high in departments with laminar air flow ventilation. Multivariate analysis also confirmed this finding. Authors argue that it may be due to the improper positioning theatre personnel in horizontal laminar flow room. Researches provided a well-researched literature review which clearly identified gap in current research. Objectives and design of the study was properly explained. Study was based on a large sample size. Results were discussed in detail and casual relations were well explained. Enough tables were used to present results. Limitations were properly discussed. Knobben et.al (2006) conducted an experimental study to evaluate how systemic changes together with behavioural changes can decreases intra-operative contamination. This study was conducted in the university Medical Centre Groningen, The Netherlands. A random sample of 207 surgical procedures which involved total knee or hip prosthesis from July 2001 to January 2004 was selected for this study. Two sequential series of behavioural and systemic changes were introduced to ascertain their role in reducing intra-operative contamination. The control group consisted 70 cases. Behavioural changes (correct use of plenum) were introduced to the first intervention group of 67 operations. Intense behavioural and systemic changes were introduced to second intervention group of 70 operations. The systemic changes introduced was the installation of new laminar flow with improved airflow from 2700m3/h to 8100m3/h. Two samples each were taken from used instruments, unused instruments and removed bon es. Control swabs were also collected to make sure that contamination was not occurred during transport and culturing. Early and late intra-operative contamination was also checked. All patients were monitored for any wound discharge while in hospital and followed-up for 18 months to check whether intra-operative contamination affects post-operative infection. Among the control group contamination was found 32.9% while in intervention group 1 it was 34.3% and in intervention group 2 it was 8.6%. Except in Group 1 (p=0.022) late phase contamination was not significantly higher than early phase contamination. During the control period wound discharge was found in 22.9% patients and 11.4% of them had wound infection later. Deep periprosthetic infection had been found in 7.1% of them in the follow-up period. Deep periprosthetic infection was found in 4.5% cases of first intervention group and in 1.4% of cases in second intervention group in the follow-up period. But none of these decreases were found statistically significant. Contamination, prolonged wound discharge and superficial surgical site infection were found decreased after both first and second intervention. But a statistically significant reduction was found only in second intervention (contamination p=0.001, wound discharge p=0.002 and superficial SSI p=0.004). This study concluded that behaviour modifications together with improved air flow system can reduce intra-operative contamination substantially. Purpose of the study was clearly defined and a good review of the current literature has given. Gap in current research was clearly presented and justification for the study had given. Sample size seems sufficient. It is reported that à ¢Ã¢â€š ¬Ã‚ ¦.bacterial cultures were taken during 207 random operationsà ¢Ã¢â€š ¬Ã‚ ¦ (p. 176), but no details of the sampling method used were provided. Details of interventions were given elaborately and results were discussed in detail. But only one table and two charts used to present it. The readers would have been more benefited if more tables were used to present the results. Discussions of the results were concise and findings were specific and satisfying the objective. No information on whether they received informed consent from the patients and approval form the ethical committee of the institution was missing. This arise a serious question about the ethics of this study. It is found that laminar airflow is more effective when use in conjunction with occlusive clothing (Charnley, 1969 cited in Sandiford and Skinner 2009). While in their recent study Miner et.al (2007) compared the effectiveness of laminar airflow system and body exhaust suits found that body exhaust suits are more effective than laminar flow system in reducing infection. For their study Miner et.al (2007) selected 411 hospitals which have submitted the claim for total knee surgery (TKR) for the year 2000 from four US States were surveyed to collect the details of use of laminar air flow system and body exhaust suits. Those hospitals which were fulfilled three criteria were included in this study. The inclusion criteria were 1) returned the survey instrument, 2) using laminar air flow system or body exhaust suits for infection control and 3) was evidence of at least one Medicare claim for TKR for the study period. Total 8288 TKRs performed in 256 hospitals between 1st January and 30th August 2000 were selected. Data on patient outcomes after total knee replacement (TKR) were collected from Medicare claims. The patients who underwent bilateral TKR were not included in this study and for those who underwent a second TKR during a separate hospitalisation during the study period, only the first procedure was included. International Classification of Disea ses, Ninth Revision (ICDS-9) codes was used to identify post-operative deep infection that needed additional operation. Hospitals were grouped as users or non-users for both laminar airflow and body exhaust suits. Users were defined as those who use any of these methods in more than 75% procedures and non-users were those use any methods less than 75%. The over-all 90-day incidence of deep infection, subsequent operation was found required only in 28 cases (that is 0.34%). Analysis found that the risk ratio for laminar airflow system was higher (1.57, 95% confidence interval 0.75-3.31) than body exhaust suits (0.75, 95% confidence interval 0.34-1.62). Study found that there were no significant differences in infection between hospitals that use specific either protective measure. Other than mentioning few studies researchers failed to provide any background of the research problem. Methods used for this study were explained concisely. Even though the sample size was large, limited number of events (28) were there to be observed. Analysis was based on this small number of events; this may have affected the result. Not many variables were included in this study, and researchers didnt mention how they controlled some possible confounders. Researchers were successful in identifying the advantages and limitations of the study. Results were properly presented in tables. Instead of expensive laminar air-flow system, installation of well-designed ventilation system is found beneficial. Scaltriti et.al (2007) conducted a study in Italy to examine effectiveness of well-designed ventilation system on air quality in operation theatre. They selected operation theatres of a newly built 300 beds community hospital which have ventilation system designed to achieve 15 complete outdoor air changes per hour and are equipped with 0.3  µm, 99.97% HEPA filters. All these satisfy the condition for a clean room as per ISO 7 standard. Passive samples of microbiological air counts were collected using Tripticase Soy Agar 90 mm plates left open thorough out the duration of the procedure. Active samples were also collected using a single state slit-type impactor. Total 82 microbiological samples were collected of which 69 were passive plates and 13 were active. Air dust was counted with a light-scattering particle analyser. Details of the surgery, number of people in the room, door opening rate and estimated total use of the electrocautery unit were also collected. It was found that there were positive correlations between particle contamination, surgical technique (higher risk from general conventional surgery), electrocauterization and operation length. Door opening rate was found negatively associated. Researchers suggest that this may because when theatre door open a turbulent air flow blows out of the operating room which may result decrease in the dust particles. No association was found between particle contamination and number of people present at the time of incision. Researchers suggest that human movement rather than human presence is the factor that determines airborne microbial contamination. It was found that average particle concentration in the theatres did not exceed the European ISO 14 644 standard limits for ISO 7 clean room, and so concluded that well-designed ventilation system is effective in limiting particulate contamination. Uncultivable or unidentifiable organisms can also be a reason for surgical site infections. It may be difficult to identify such organisms through standard culture techniques (Tunney 1998). Clarke et.al (2004) conducted a quantitative study to examine the effectiveness of ultra-clean (vertical laminar flow) theatres in preventing infections by unidentifiable organisms. They used the molecular technique, Polymerase Chain Reaction (PCR), to detect bacteria presence. Their study compared the wound contamination during primary total hip replacement (THR) performed in standard and ultra clean operation theatres. 20 patients underwent primary THR from 1999 to 2001 were recruited for this study. Patients with previous incidents of joint surgery or infection were excluded. The standard operation theatres had 20 air changes per hour and CFU count was 50 CFU/m3, while ultra-modern theatres had 530 air changes per hour and CFU count was 3 CFU/m3. For all surgeries same infection control precautions were used. Two specimens each of pericapsular tissues were collected from posterior joint capsule both at the beginning and at the end of the surgery (total 80 samples). Patients were given antibiotic prophylaxis after taking the first specimen. All these samples were underwent Gram stain and culture to detect bacterial colonies and Polymerase Chain Reaction (PCR) to detect bacterial DNA. Among the 20 specimens taken form the standard operation theatres at the beginning of the surgery only 3 were found positive with PCR, while from the ultra-clean theatres only 2 were found positive. None from both theatres found positive with culture. Samples from the standard theatres taken at the end of the surgery, 2 found positive by culture and 9 found positive by PCR. The contamination rate in the standard theatre at the end of the surgery found significantly greater than the beginning (p=0.04). Samples taken from the ultra-clean theatres, none was positive by culture while only 6 were positive by PCR. Statistical analysis found that contamination rate at the end of the surgery is not statistically different than the start (p=0.1). It was found that there were no statistically significant difference in overall contamination rate (p=0.3) between standard and ultra clean theatres. (I will add critique of this study here) NURSES ROLE IN INFECTION CONTROL Understanding the source of contamination in operating theatre and knowing the relationship between bacterial virulence, patient immune status and wound environment will help in improving the infection rates (Byrne et al 2007). Nurses are responsible to take a proactive role in ensuring safety of their patients. To improve patient outcome, it is necessary for the nurses to take lead role in environmental control and identifying hazards through environmental surveillance (Neil 2005). Non-adherence to the principle of asepsis by surgical team is identified as a significant risk factor of infections. Hectic movement of surgical team members in the operating room and presence of one or more visitors were also found as major causes of SSI (Beldi G 2009). Nurses and managers should emphasise on controlling factors like the traffic in theatre, limiting the number of staff and reinforcement of strict aseptic technique (Allen 2010). Creedon (2005) argues that infections can reduce up to one third if staffs follow best practice principles. For better outcome staffs needs additional education and positive reinforcement. Nurses have a vital role in the development, reviewing and approving of patient care policies regarding infection control. Nurses are not only responsible for practicing the aseptic techniques but also responsible for monitoring other staff for their adherence to policies. They are responsible for developing training programmes for members of staff. Educating the environmental services personnel like technicians, cleaners will not only improve their knowledge in patient care but also provide a sense of commitment in patient outcomes (Neil 2005). Perioperative nurses can contribute in research regarding theatre ventilation system through organised data collection and documenting evidences. Nurses can contribute in giving optimum and safe delivery of care in areas where environmental issues can put the patient at risk. Knowledge is changing fast, so it is important that staff must keep themselves up to date. Continues quality improvement is needed and it should be based on evidence based research and on-going assessment of information (Hughes 2009). CONCLUSION Reviews of current research shows that still there is a lack consensus on the effectiveness of laminar airflow in infection control. Studies include in this review has used either clinical outcomes (infection or reoperation rate) or intermediate outcomes (particle count or bacterial count) to evaluate the effectiveness of laminar flow. Kakwani et.al (2007) found that re-operation rate was lower in laminar airflow theatres but Brandt et.al (2008) found SSI rate was high in hospitals with laminar flow. Clarke et.al (2004) found that contamination was not significantly different in ultra clean theatres compared to standard theatres equipped enhanced ventilation system. Supporting this finding Scaltriti et.al (2007) found well designed ventilation system is effective in reducing contamination. Study by Knobben et.al (2006) found that combination of systemic and behavioural changes are required to prevent intra-operative contamination. Miner et.al (2007) found that there were no significant differences in infection between hospitals that use laminar airflow and body exhaust suits. From these studies it can be concluded that use of laminar airflow alone can guarantee infection prevention. Behavioural and other systemic changes are necessary to enhance the benefits of laminar airflow. Evidence shows that conventional theatres equipped with enhanced ventilation system can prevent infection effectively, this can be consider as an alternative for expensive as laminar flow system.

Oedipus Rex as Social Commentary Essay -- Oedipus the King Oedipus Rex

Oedipus Rex as Social Commentary Oedipus Rex, written by the Poet Sophocles in the Golden Age of Greek Theatre, was described by Aristotle to be the greatest tragedy of all time. It encapsulates the very essence of the Greek cultural milieu, and it is these ideologies which are translated into the play. The very essence of Greek society; the political democracy, a moral belief in the power of the Gods and social recognition of hierarchy, are portrayed when the society is pictured in a state of chaos. The Ancient Greeks formulated what they believed to be a true democracy. Everyone was to have a say in the political scene, every man had a vote and no one should be disadvantaged. At the same time, however, the society was very much a patriarchal one. Power resided with the male; the leader, the logical and strong enforcer. Women, viewed as emotionally erratic, illogical and weak, were marginalised. Men were given the most noble of duties surrounding the glory of war; women were faced with trying to raise a household. This conflict is clearly portrayed in the text. In the opening scene all are equal. Servants, peasants and royals alike proclaim, "We are your suppliants." All have an equal interest in the state of Thebes and the actions Oedipus must take. After this, however, the females of Thebes are represented in the characterization of Jocasta. It is here that the chorus, the most important element of Greek tragedy, comes to the fore. As the Theban elders they portray the views of the greater society. Jocasta's actions characterize her as the stereotypical female. By ordering the death of her son, blaspheming the Gods and eventually killing herself, she shows the essential perceived frailty of w... ...ssenger must talk to Oedipus through Jocasta. Eventually, Oedipus shows his respect that that this order exists by imploring him to 'tell me yourself!' A play represents society. By upsetting the societal order, the basic fundamentals of the societal group can be examined. In the case of Oedipus Rex, Sophocles portrays the basics of the Ancient Greek culture, the culture which existed in his time. He exposes a patriarchal society, one attempting to come to grips with democracy while at the mercy of the Gods. The social hierarchy is respect but forced to crumble, while the Gods rule it absolutely. All of this is exposed through the underlying conventions, mainly the chorus, dramatic action, dialogue, characterization and methods of social construction. It forms an in-depth exposition of the group and its formation of the beliefs and values.

Essay --

This paper explores the relationship of the pathogenicity of the opportunistic bacterium P. aeruginosa specifically related to the pathophysiology of cystic fibrosis and the impact they have on patient care and nursing. Cystic fibrosis is a life-threatening, immunosuppressing genetic disorder unto itself, but is a primary cause of opportunistic infection. Studies show that  ¬P. aeruginosa infections, common and often chronic and lethal in CF cases, are most often established between ages 0-3 years in a CF patient and develop undetected until the infection is well established and difficult to treat. Because of physical complications related to a child’s age, immunosuppression exhibited by those affected with cystic fibrosis, versatile nature of the pathogen’s virulence and wide array of habitable environments, and comorbid factors the pathogen contributes to mortality among infected hosts, it is imperative that thorough diagnostic, preventative, and treatment measures be taken regularly and begun as early as possible with a cystic fibrosis infant in order to reduce prevalence and incidence of chronic lung infection. Nursing responsibilities include administration of long-term therapeutic medications, parental teaching, lifestyle planning, maintaining optimal health and vigil monitoring in the clinical setting, referrals, and improving the affected child’s overall growth, development, and happiness. â€Æ' P. aeruginosa in Young Children with Cystic Fibrosis The nature of an immunosuppressing disease among infants invites infection from bacteria normally a part of our normal flora. P. aeruginosa, a common hydrophilic bacterium found in most environments high in moisture, exhibits little virulence until it successfully invades the tissu... ... a necessity, especially during times of hot weather, fever, and excessive exercise in order to prevent hyponatremia. (Nettina, 2010) The nurse should actively encourage the parents to seek ongoing education about their child’s disease and share CF information with family members, teachers, school nurse, and anyone who would care for the child. It may be beneficial to refer the family for social work or support groups dedicated to CF. The nurse should also stress the importance of regular medical care and to pay attention to advances in treatment, recommending several pulmonary function tests, respiratory cultures, and liver enzyme analyses per year. Parent education regarding proactive roles in their child’s health care generally increases the child’s quality of life and longevity and promotes optimal development and growth. (Nettina, 2010; Porth & Matfin, 2009)

Does Delegation Help or Hurt Nursing?

The first nursing school was established in India in about 250 B.C., and only men were permitted to attend because men were viewed to be more pure than women. If you think of a woman dressed in scrubs with a stethoscope around her neck and a clipboard in her hands, you aren’t alone. An overwhelming majority of nurses in the United States today are women. However, nursing began as a practice reserved for men. It wasn’t until the 1800's that nursing became an organized practice.During the Crimean War, Florence Nightingale and 38 volunteer nurses were sent to the main British camp in Turkey. Nightingale and her staff immediately began to clean the hospital and equipment and reorganized patient care. Nightingale pushed for reform of hospital sanitation methods and invented methods of graphing statistical data. When she returned to Britain, Nightingale aided in the establishment of the Royal Commission on the Health of the Army. As a woman, Nightingale could not be appointed to the Royal Commission, but she composed the Commission’s report. (Travel Nurses of America, 2010) Completed, the report was over 1,000 pages in length and included detailed statistical information.Nightingale’s work led to drastic changes in army medical care, the establishment of an Army Medical School and medical records, and ignited the growth of nursing as an organized profession. For these contributions, Nightingale is widely accepted as the founder of nursing. Ironically, nursing has been taken on as a feminine profession, although as aforementioned, that was not its intention. Nursing are an extremely vital component of health care settings. According to the World Health Organization, nursing is defined as such: â€Å"Nursing encompasses autonomous  and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. It includes the promotion of health, the prevention of illness, and the care of ill, disabl ed and dying people.† (WHO, 2011)Keeping that definition in mind, nurses ensure that patients are being taken care of properly and efficiently. It is obvious that one nurse alone cannot do all the work that a health setting requires. This is where the idea of delegation comes into play. One of the vitals skill required by the Registered Nurse is the skill to assign tasks to subordinates (Saccomanos and Pinto-Zipp, 2011). When tasks are delegated to subordinates, the RN remains accountable (Nursing and Midwifery Council 2008). This concept of work delegation has positive and negative effects.On one hand, it helps the RN (Registered Nurse) do more work in a shorter period of time, yet the downfall is that if the subordinate makes any mistakes, the results could be fatal and would still rest solely on the hands of the RN. Hence, delegation involves â€Å"responsibility, accountability and authority† (Sullivan &ump; Decker 2005, p. 144). This research paper will analyze the role of a RN in relation to delegation.Chapter Two: Nursing and Delegation- Who Does What? This essay will examine the role of the registered nurse in relation to delegation. Areas that will be examined include definitions of delegation, benefits of distributing workloads, management in relation to delegation, nursing process and procedures when delegating, common mishaps of delegation, five rights of delegation, and barriers nurses must break through when to delegating. In conclusion, this paper will hopefully convey the importance of an RN, delegation, and how this effects the quality of care patients receive.Delegation can be a useful tool that cuts costs, or a costly disaster waiting to happen From a management prospective, delegation is the idea of assigning tasks to other employees that a manager is currently undertaking. While delegation can be extremely helpful for speed, the question of efficiency and accuracy come into play. Delegation is seen as a daily routine in clinic al settings which can be traced back even to the Bible. Moses delegated to his Father-in-Law Jethro, asking why would everyone sit around and have you work alone? But what does delegation mean to Nursing? Delegation, as defined by the American Nurses Association, is  the ability to handover responsibility for the performance of a duty from one person to another while being held accountable for the outcome. (ANA, 2005)While effective, delegating another person in a health setting has its risks. Supervision is an essential tool in delegation because it involves direction, evaluation and follow up which must be provided by the RN to those she/he is delegating the task to (Finkelman 2006). However, the National Council of State Boards of Nursing (1995) also defines delegation as giving authorization to a capable individual to execute a particular nursing task in a particular situation. According to Lookinland, author of Team Nursing, the Registered Nurse was solely responsible for the care of the patients but due to staff shortage, budgetary constraints and high rate of sicker patients, the need to delegate duties to other Non-Registered personnel arose.(Team Nursing, 2005)Delegation provides a lot of benefits for both the organization and the staff. Cost effectiveness and time savings have been identified as the benefits of delegation as these helps the organization to utilize resources and staff in an appropriate manner (Finkelman 2006). Consequently, Pearce (2006) suggested that delegating repetitive tasks could lead to RN’s time being used efficiently for other tasks. Moreover, when tasks are assigned to others, it leads to the tasks being done in an efficient manner and an increase in productivity (Finkelman 2006).In the same light, Potter et al. (2010) stated with delegating duties to other staff, professional growth can occur as these staff have the opportunity of learning new skills, and having enough time in engaging in other activities. When del egation is used in an effective way, it builds up teams and improves quality care (Finkelman 2006). Chapter Three: Nursing and Delegation- Management Theory.Delegation can be direct (such as verbal instructions e.g. assisting patients with activities of daily living) and indirect which involves activities carried out based on hospital policies (Masters 2009). Nursing management, when referring to Maslow’s Hierarchy of Needs, is a useful organizational framework that can be applied to the various nursing models for assessment of a patient’s strengths, limitations, and need for nursing interventions. (Smeltzer SC, Bare BG, 2004) It is noteworthy to state that in relation to delegation, the registered nurse who delegates task retains accountability and responsibility for such task (ANA 2005).Due to the risks and various factors in a health setting, it is important that a RN keeps in mind that when delegating task to any individual, the task should be well understood and t hat the individual carrying out the task should be knowledgeable, trained and competent enough to carry out the task being delegated (Masters 2009). Accordingly, and when good management is implemented among the nursing staff, when authority is passed from the RN to the delegate during delegation, it is appropriate to inform other members of the organization as they need to be aware of which task has been allocated and to who. It is also imperative for the employee to have access to resources as well as for the RN to allow the employee to take control of the task (Finkelman 2006).Also, in the textbook, Fundamentals of Nursing, Patricia Potter stated that when delegating task, the RN must ensure adequate two way communication. Communication should be clear, brief and complete as effective communication is a key element of delegation (Potter et al. 2010). As a result, good communication allows the unlicensed personnel to ask question and seek clarifications where necessary. The RN sho uld ensure that the unlicensed personnel understands what the delegated task entails and that he/she readily accepts the delegation as well as the responsibility that goes with (Finkelman 2006). Therefore, where the RN feels that when delegating task to unlicensed personnel may be unsafe, or that the person lacks competency or if she/he feels they may not be available to supervise such task, she/he has the right to inform the manager and refuse to delegate the task to any person they deem unfit. (NMC 2008)Furthermore, as indicated by the NMC (2008), no one should be under any form of pressure to either delegate or agree to do a delegated task. Many times nurses have strengths and weaknesses in their profession. It is important to understand or recognize a nurse who is uncomfortable with a task or struggling. Management should also make it clear that staff should communicate to management if they need assistance.Chapter Four: How is Nursing Organized? How is delegation run? In nursin g, there are several categories that an RN can fall into. There are matron nurses, director of nursing, nurse managers and charge nurses. The matron nurse is the head senior nurse and in charge of delegation and subordinate  tasks. If tasks and duties fail to be met, they are held accountable. The director of nursing is also a senior nurse, but tend to report to the CEO of the hospital. They oversee all tasks done by the matron, registered nurses and nurse managers. They are responsible for producing data and ensuring standards are being met.Nurse Managers are responsible for a nursing unit and typically report to the matron. They are given a unit of nurses and delegate tasks and patients to them. And then there is a charge nurse who is the frontline of management for the nurses on a shift. The charge nurse oversees all the RNs. Registered nurses are extremely important in terms of delegation. Registered nurses are above certified nurse’s assistants and licensed nurse pract itioners. It is crucial that an RN supervises and gives feedback on tasks that are performed because this creates an avenue for the subordinate to know where or what went wrong and how it could be improved upon to deliver quality health care. (Pearce 2006)In delegating tasks to an unlicensed personnel, the RN decisions should be based on the delegation process (that is assessment, planning, implementation and evaluation) which will help in reducing the risk associated with delegation (Newmann 2010). The assessment stage looks at if the delegated task is suitable for the delegate. The planning stage involves determining the competence of the individual to carry out the task and ensuring safety measures, implementation deals with the RN observations through supervision and evaluation gives a breakdown of the completion of the task (Neumann 2010). This process as indicated by Neumann (2010) is done to protect the nurse and employers against any legal issues that may arise as well as fo r the safety of the patients.Chapter Five: Nursing Delegation to Unlicensed Persons. Delegated duties to unlicensed personnel must be within their scope of practice for which that person has the training and not tasks that may require having a certificate or license (Zimmerman 2001). Tasks which may be delegated to unlicensed personnel’s include tasks like activities of daily living, taking vital signs, errands and clerical duties (Zimmerman 2001). Other tasks which Zimmerman mentioned should not delegate by the RN to unlicensed personnel include duties such as nursing skills that involve invasive procedures, expert knowledge and professional decisions relating to  patients care.If the RN delegates tasks inappropriately, it could lead to the loss of her/his registration license and issues of liability may need to arise (Finkelman 2006). Before an RN delegates a task to individual or unlicensed personnel, care must be taken into consideration in relation to assessing proper training and level of competency of the individual regardless of how easy the delegated task may appear to be (NCSBN 2005). Unfortunately, the results of a failed task or malpractice do rest on the RN. It is important to delegate to knowledgeable individuals who understand their task fully.Chapter Six: Procedure, Policies, and Error. There are certain errors and mistakes that occur during delegation. The most reported errors include over delegation, under delegation and improper delegation (Feldman et al. 2008). Over delegation arises when time management skills are not properly developed in an individual or where one is not too sure about their own capability to carry out a task (Feldman et al. 2008). Under delegation as stated by Feldman (2008) happens when the RN has no confidence in the subordinate to perform the task which is to be delegated while improper delegation means delegating task outside an individual’s expertise.In order to avoid such common mistakes and being a professional, when delegating task, the RN must be familiar with the five rights of delegation which the NCBSN (1995) identified as right task, right circumstance, right person, right direction and communication, right supervision and evaluation. The right task has to do with deciding if a task should be delegated for a specific patient. The right circumstances looks at the client’s environment, client’s conditions and available resources. The right person takes into account the right individual delegating the right task to the right person to carry out the task on the right patient.The right direction or communication focuses on communication being clear and having a concise description of the task explained including all expectation for having the tasks accomplished. The right supervision deals with monitoring the task, implementation, evaluating task and also providing feedback in relation to the task (ANA 2005). These rights as noted by the NCBSN (2005) assists t he RN to determine a suitable and appropriate method to use during delegation. Delegation is seen as a process which the RN has  to be properly equipped and well educated in (Finkelman 2006). However, delegation can become problematic in relation to shortage of staff, having to do obnoxious task and the inexperience of the subordinates (Curtis and Nicholl 2004).Chapter Seven: Impact on Administration. Administration will then face a barrier such as lack of trust in the subordinates which leads to the attitude of â€Å"doing it all by myself† (Feldman 2008). This can affect effective delegation because when leaders lack trust in their subordinate’s capabilities, they are likely to make mistakes (Feldman, 2008). Similarly, some RNs may feel they are perfectionist and as a result are unlikely to delegate because of the fear of having to deal with any negative outcomes by the subordinates (Curtis and Nicholl 2004). This causes hostility within administration. It is very expensive to have head nurses on the floor, yet if they won’t delegate workload, they must be there.This causes cost to go up, speed to go down, and employee trust to diminish. In relating this to clinical practice, some nurses may not be willing to delegate tasks to student nurses for fear of being held accountable for any mistakes. As stated by the NMC, the RN who decides to delegate is held accountable for such delegation. It causes a lack of trust on the floor from one employee to another. Another barrier as identified by Curtis and Nicholl (2004) occurs when there is shortage of staff or having inexperienced staff members. This leads to staff being overburdened with work load. As suggested by Curtis and Nicholl (2004), when there is shortage of staff, it is imperative for the work load to be lessened until there is an improvement in the availability of staff.Chapter Eight: Impact on Management. Many nurses may feel that tasks that are beneath them can be constituted as a barrier in delegation. As indicated by Feldman (2006) when managers discriminate by delegating tasks which may be unpleasant or boring to certain subordinates and keep the better or interesting tasks for certain people, it leads to subordinates refusal to perform such tasks. For this reason, it is essential to assign task which are interesting and task should be assigned equally and fairly to all individuals concerned taking into account their skills and ability (Kourdi 1999).This impacts management negatively. It causes the head nurses to get away with picking and choosing their tasks while the employees beneath them become frustrated and annoyed. Tasks must be divided up fairly, not just because the head nurse does not want to do them.Conclusion: In conclusion, delegation as discussed in the essay is considered to be an essential aspect of nursing and play an important role for the RN. As Marquis and Hustin (2008) stated, â€Å"delegation is a necessity and not an option†. So it is important that nurses as well as students preparing to become nurses are well trained and equipped in this field. As someone who is going to school in September for Nursing, I am fully aware that delegation is vital. If there is a team effort, then tasks will get done much faster and much more accurate.Delegation is an important nursing skill which requires a systematic plan to ensure optimal patient care (Finkelman 2006). Referring back to Maslow, nursing needs to be organized and delegated appropriately. Delegation is a skill that can be calculated to minimize costs, maximize quality, and ensure effectiveness. More management courses in health care should be given to depict how to delegate properly, not just with nursing, but perhaps with all health care personnel. Since delegation improves with practice, it is important for nurses understand when to delegate and how.Learning these skills will also prepare the nurses in future to delegate task when they qualify and becom e RN’s. In relation to nursing practice, registered nurses should help other nurses by delegating tasks to them that are within their level of competence as well as making sure that all tasks assigned to them are duly supervised and follow up on the delegated task.

Organisational Devlopment: Levels of Diagnosis Essay

It is pointless conducting diagnosis at the individual level, because most issues can be addressed at the organization and group level. Discuss. Within modern business practices continual evolution is essential for long term organisational outcomes. With economic pressures, a growing demand for perceptibly social and environmental responsibility and an increasingly focus towards international and worldwide trade, modern organizations are confronted with an almost constant need for change (Waddell, Cummings and Worley, 2007). Thus it is important for leaders to have a sound understanding of change issues and theories (Waddell, 2002). Organisational development (OD) is described as a systematic application of behavioral science knowledge to the planned development and reinforcement of organizational structures, processes and strategies for improving organisational effectiveness (Waddell et al. , 2007). Diagnosis it an integral part of successful OD implementation and is performed on one or more levels including ‘individual’, ‘group’ and ‘organisational’ diagnosis. Thus for successful long term outcomes it is necessary to investigate the role of diagnosis within successful OD implementation, with a focus on ‘individual’ level diagnosis in contrast to both ‘group’ and ‘organisational’. Diagnosis within organisation development is described as an intervention that develops information about the various subsystems of an organisation as well as the patterns and processes that take part in an organisation (Beckhard, 1969). Similarly, Waddell et al. 2007) depict diagnosis as the process of understanding how the organisation is currently functioning, in order to successfully develop change intervention. Thus within modern firms this process develops insight for both the client and OD coordinator into the functioning and efficiency on individual, group and organisational levels. Aldefer and Brown (1975) suggest that the process of diagnosis also serves to motivate organisational members to engage in change. Nadler (1977) reinforces this, depicting that diagnosis provides employees or members with a direction for change. As such, diagnosis within OD has been described as the ‘key’ in developing successful interventions (Burton & Obel, 2004). As well the diagnostic process is referred to as collaborative between OD consultant and client (Stacey, 2007), in which the two parties work together to develop action plans for effective change process. Waddell et al. (2007) reinforces this suggesting that the values and ethics that underlie OD suggest that both change agents and organisational members should be involved in developing and implementing appropriate interventions. Organisations, when viewed as open systems can be diagnosed as three levels, including organisation, group and individual (Waddell et al. , (2007). The highest level is the organisational level and includes the design of the organisations structure, strategy and processes. The next level consists of groups or departments within the organisational structure, including group design and interaction devices. The lowest level of organisational diagnosis is the individual level, including job design and personnel characteristics. Todnem (2005) suggest organisational diagnosis can occur at all three levels or it may be limited to problems that occur at a single level. For example, if there was a problem with output resulting from a single job design there would be only need for individual level diagnosis. Similarly Coghlan (1994) illustrates that the key to effective diagnosis is to know what to look for at each level, as well as how the levels affect each other. Waddel et al. (2007) depict the organisational level of diagnosis as the broadest systems perspective that is typically taken in diagnostic activities. This level focuses on the organisation against inputs such as the general environment and industry structure to achieve outputs such as performance, efficiency and stakeholder satisfaction through strategy and organisational design. Todnem (2005) suggests that design components within this level can also include HRM, culture and technology. Similarly the general environment can include a vast amount of extraneous variables including social, technological, economical, ecological and political (Stahl, 1997). Thus this level provides a broad basis for diagnosis within the largest environment. As such this level of diagnosis is most crucial when designing or redesigning action plans focused around the organisation as a whole. These strategies may include organisational goals and objectives, mission or organisational policies. (Waddell et al. (2007). Modern organizations are developing action plans in order to change practices to incorporate environmental and social responsibility. These plans and interventions designed at achieving change include organisational wide strategies, such as redesigning business infrastructure as well as changing major mission values/goals and policies within those companies. An example of integrating effective organisatinoal diagnosis is RIO TINTO’s continual development and change towards more sustainable, environmentally responsible mining processes in order for long term outcomes (RIO TINTO, 2010). Through external forces or inputs they developed and integrated various interventions to remodel major sectors within the firm completely. Thus developing and maintaining successful strategic design requires effective organisational diagnosis. The next level of diagnosis is group, and can apply to both larger operating division of firms such as BHP Billiton, or to smaller departments within organisations (Waddell et al. , 2007). Coghlan (1994) depicts that division or larger groups within such multinational firms generally follow the same dimension and relational fits applicable to organisational level development. Inversely Waddell et al. (2007) suggest that small departments and groups behave differently from larger divisions or organisations and thus require a suitable diagnostic model to reflect those dimensions. As such, group level diagnosis consists of organisational design as an input, resulting in outputs of team effectiveness through design components such as task structure, group functioning, performance norms, group composition and goal clarity. Stahl (1997) describes group diagnosis as relative to a small number of people working face to face on a shared task or program. Laser (1995) suggests supportive organisational design is crucial for effective groups to operate. Harrison and Shirom (1999) reinforce this depicting that group structure and components are highly interrelated to organisational wide strategy and design. Goal clarity is a major design component within group level diagnosis, and refers to how well the group understands its objectives. Waddell et al. (2007) suggest that goals should be understood by all members, moderately challenging, measurable, and monitored and, have structure for providing feedback of achievement. An example may include group targets for sales teams. Stahl (1997) illustrates that goal clarity is of crucial importance to successful group outcomes. Coghlan (1994) reinforces this depicting that clear goals provide motivation and direction to group dynamics. Group level diagnosis is considered a more specific approach to an internalized problem than organisational diagnosis and can include problem solving groups built for a specific function (Stahl, 1997). However organisational and group levels remain highly interrelated through organisational design. The lowest level of diagnosis is the individual job or position. Waddel et al. (2007) suggest that organisations are made up of numerous groups and in turn, those groups are composed of several positions. Callan (1993) depicts individual diagnosis as highly specified and dynamic. Similarily Stahl (1997) described the individual level diagnosis as having a minimal effect on the organization as a whole. As the individual level focuses on a single job design it requires a new model of job-level diagnosis (Waddell et al. , 2007). The inputs within this level are organisational design, group design and personnel characteristics, and the resulting outputs aimed at achieving are individual effectiveness, through performance, job satisfaction and individual development. The design components utilized to transform the inputs within this model are skill variety, task identity, autonomy, task significance and feedback about results. Coghlan (1994) suggests that effective feedback mechanisms are crucial to continual intervention and employee development. Feedback refers to the degree to which employees are provided with clear information about performance and effectives of their activities (Waddell et al. , 2007). Such mechanisms could include both formal and informal methods such as casual on the spot feedback or yearly performance appraisals. Conversely Callan (1993) depicts task significance as a major influence on outcomes within the individual level, suggesting that the level to which the employee’s job impacts on other people’s lives has a powerful affect on resulted outcomes. Individual level changes and restructuring can result in higher outcomes of individual’s position through higher individual interest and personnel investment in their jobs (Waddell et al. , 2007). As well higher productivity on an individual level transfers to more successful organisational outcomes, and thus benefits both the workers and the firm. The importance of diagnosis on an individual level can be relatively debatable dependent on organisational type, infrastructure and individual job function (Mclean, 2005). Individual level diagnosis relies on organisational design, group design and personal characteristics for transference into outputs (Waddle et al. 2007). Thus this job level is highly interrelated and dependent on the effectiveness of the design components of both organisational and group level. Hence, effective intervention development within the first two levels of diagnosis would result in a large proportion of successful outputs on an individual level (Harrison and Shirom, 1999). Conversely personal characteristics can include dynamic and uncontrollable extraneous variables which may result in a varied output on the job level. (Burton & Obel, 2004). Thus in order to limit a varied result within output it may be necessary to conduct individual diagnosis of job design relevant to the specific problem or concern. As well Mclean (2005) emphasizes the importance of employee satisfaction in relation to staff turnover in order for long term development and organisational outcomes. Waddel et al. (2007) reinforce this depicting a ‘two sided’ relationship between employee satisfaction and interest and the consequential favorable outcomes for the firm. Cobb (1986) illustrates that redesigning individual level jobs can be crucial for successful outcomes within specified problems. As well Beer and Spector (1993) suggest that the success of OD interventions rely heavily on the accuracy of diagnosis within organisations. Thus for a higher probability of favorable outcomes for developed interventions it is necessary to conduct diagnosis over all three levels. Organisational development is a critical process for both short and long term outcomes within modern business practice. With growing economic, social and environmental pressure, there is a greater need for organisational change than ever before. Successful OD is heavily reliant on the effectiveness of diagnosis within an organisation in order to develop appropriate interventions to develop change within the firm. All three levels of diagnosis within OD are important to developing effective mechanisms for change. Organisational diagnosis is more responsive to external influences and direct pressure for both social and environmental concerns. However both group and individual levels are highly interrelated with the success of change interventions and in particular the development of productivity and efficiency to provide support against the economic strain. Individual level diagnosis is highly interrelated within the other levels and as such may not be necessary within some OD applications.