Critical Incident analysis of a clinical setting

Critical Incident analysis of a clinical setting The purpose of this essay is to reflect and critically study an incident from a clinical setting whilst using a model of reflection. This will allow me to analyse and make sense of the incident and draw conclusions relating to personal learning outcomes. The significance of critical analysis and critical incidents will briefly be discussed followed by the process of reflection using the chosen model. The incident will then be described and analysed and the people involved introduced. (The names of the people involved have been changed to protect their privacy) and then I will examine issues raised in light of the recent literature relating to the incident. My essay will include a discussion of communication, interpersonal skills used in the incident, and finally evidence based practice. I will conclude with explaining what I have learned from the experience and how it will change my future actions. In accordance with the 2002 Nursing and Midwifery Council, the clients details and placement setting has not been disclosed in order to maintain confidentiality. Critical incidents are snapshots of something that happens to a patient, their family or nurse. It may be something positive, or it could be a situation where someone has suffered in some way (Rich Parker 2001). Reflection and analysis of critical incidents is widely regarded as a valuable learning tool for nurses. The practice requires us to explore our actions and feelings and examine evidence-based literature, thus bridging the gap between theory and practice (Bailey 1995). It also affords us the opportunity of changing our way of thinking or practicing, for when we reflect on an incident we can learn valuable lessons from what did and did not work. In this way we develop self-awareness and skills in critical thinking and problem solving (Rich Parker 2001). Critical incidents To be self aware is to be conscious of ones character, including beliefs, values, qualities, strengths and limitation. It is about knowing oneself (Burnard 1992). I am going to use Gibbs (1988) Reflective Cycle. This because Gibbs is clear and precise allowing for description, analysis and evaluation of the experience helping the reflective practitioner to make sense of experiences and examine their practice. Taking action is the key; Gibbs prompts to formulate an action plan. This enables the reflective practitioner to look at their practice and see what they would change in the future, how they would develop/improve their practice. Gibbs (1988) consists of six stages to complete one cycle which is able to improve my nursing practice continuously and learning from the experience for better practice in the future. The cycle starts with a description of the situation, next is to analysis of the feelings, third is an evaluation of the experience, fourth stage is an analysis to make sense of the experience, fifth stage is a conclusion of what else could I have done and final stage is an action plan to prepare if the situation arose again (NHS, 2006). Baird and Winter (2005, p.156) give some reasons why reflection is require in the reflective practice. They state that a reflect is to generate the practice knowledge, assist an ability to adapt new situations, develop self-esteem and satisfaction as well as to value, develop and professionalizing practice. However, Siviter (2004, p.165) explain that reflection is about gaining self-confidence, identify when to improve, learning from own mistakes and behaviour, looking at other people perspectives, being self-aware and improving the future by learning the past. In my context with the patient, it is important for me to improve the therapeutic relationship which is the nurse-patient relationship. In the therapeutic relationship, there is the therapeutic rapport establish from a sense of trust and a mutual understanding exists between a nurse and a patient that build in a special link of the relationship (Harkreader and Hogan, 2004, p.243). REFRENCE ON CONFRONTATION!! Description My reflection is about one patient whom I code her as Mrs. Adam, not a real name (Appendix I) to protect the confidentiality of patients information (NMC, 2004). In this paragraph I would describe on the event takes place and describe that event during my clinical placement. I was on a surgical ward nursing Mrs Adam under supervision of my mentor when during ward round I was asked to remove Ms Adams wound dressing so the doctor can assess the wound, therefore I removed it using aseptic technique and cleansed the wound. I stayed with the patient whilst my mentor attended to another patient. When the doctor arrived from visiting another patient I observed that he came directly to Ms Adams without washing his hands or using alcohol gel and was wearing loose watch and I was concerned this would infect Ms Adams wound. At that moment I was thinking to speak up and say something however I dismissed enough courage to confront the doctor and thought it was too late as the doctor already start ed examining Ms Adams. Feelings In this paragraph, I would discuss on my feelings or thinking that took place in the event happened. I was shocked that the doctor did not wash his hands or use alcohol prior examining Ms Adams especially with all the infection control guidelines and protocols in place. In spite of this I did not have confidence and felt intimidated due to the fact the doctor was more knowledgeable and experienced than I was as a first year student, also I did not want to make him feel uncomfortable. Furthermore I did not want the patient to feel alarmed and worried by challenging the doctor whilst Ms Adams was there. However soon after I had a word with my mentor and told her what I observed and she then recommended that together we confront the doctor, therefore the next day my mentor spoke to him in private and she asked him if before examining Ms Adams whether he washed his hands. The doctor seemed stunned by this conversation but admitted he did not wash his hands. He responded by justifying his actions and saying he was busy and was in a rush to remember. My mentor discussed the significance of infection control and hand hygiene and then the doctor promised her that he would make sure he follows the protocols and cleanses his hands prior examining any patient in the future. Evaluation This event was difficult and challenging for me as I felt disappointment for my lack of confidence in not confronting and challenging the doctor prior him examining Ms Adams, on the other hand I felt content in the way the doctor responded so positive and optimistic. Consequently I observed that doctor has now changed his practice as a result of this incident. I have learnt from this incident the importance of acting assertively with staff members in a sensitive approach in order to safeguard patients health. Analysis Nurses have a responsibility to safeguard and promote the interests of individual patients and Clients (NMC 2004). This responsibility include ensuring that his or her knowledge and competencies commensurate with the task being undertaken. Infection is responsible for increased morbidity and mortality, thus a comprehensive knowledge of infection control precautions and basic microbiology should be a fundamental requirement of all healthcare professionals. Hands must be decontaminated before every episode of care that involves direct contact with patients skin or food, invasive devices or dressings. Current expert opinion recommends that hands need to be decontaminated after completing an episode of patient care and following the removal of gloves to minimise cross contamination of the environment (Boyce and Pittet, 2002; Pratt et al, 2001) Hand hygiene is a crucial factor in the control of HAI because hands can easily transfer micro-organisms from one area or patient to another. Despite strategies promoting hand hygiene there still seems to be difficulty persuading staff to adopt good practice (Shuttleworth, 2004). Doctors are the worst offenders. According to NHS figures, 25% of them fail to follow basic hand-washing procedures, compared with 10% of nurses and 15% of ancillary staff. From The Sunday Times December 21, 2008 Royal College of Nursing (RCN, 2009)Studies show that uniforms may become contaminated by potentially disease-causing bacteria, including Staphylococcus aureus, Clostridium difficile, Although it has been suggested that uniforms act as are servoir or vector for transmission of infection in hospitals, no evidence is currently available linking the transmission of bacteria to patients (Wilson et al., 2007).However, it is important to note that all clothing worn by all staff (for example, doctors, therapists and cleaners) has the potential to become contaminated via environmental micro-organisms, or those originating from patients or the wearer, and that nurses uniforms are not unique in that respect. This reinforces the need to ensure all clothing worn by staff in all clinical areas is fit for purpose and able to withstand laundering. Advocacy ranges from activities on behalf of patients, such as hand washing and proper identification before treatments, to arguing that an early discharge will harm her patients recovery. According to Arnold and Boggs 2003) assertive nurse is able to stand up for the rights of others as well as for his or her own rights. Some benefits of assertiveness identified by Rungapadiachy (1999) include being respected for being honest and fair, developing a sense of self respect and having the ability to establish good interpersonal relationships with others Becoming more self-aware seems to be a very important concept to nursing practice. Driscoll (2000, p17) states that reflective learning will help you become more self-aware in your clinical practice. As the student nurse caring for Mr Khan under my mentors supervision, this also applies to my own practice as a student nurse. Conclusion In hindsight I feel I should have confronted the doctor at that moment and acted sooner. I also should have made sure the doctor washed his hands prior examining the patient. I realise how I put Ms Adams heath at risk. Following conversation with my mentor acknowledged that I need to develop the confidence to challenge the practice of colleagues, understanding pressures that may be under but ensuring that their practice does not put patients at risk. If a nurse observes a practice or procedure she believes to be wrong, advocating for her patient demands she speak out even if that practice was carried out by her superior. This is not always easy and may have a cost for the nurse. I realise that I need to be supportive to colleagues, understanding the pressures that they may be under, but ensuring that their practice does not put clients at risk. Action Plan My action plan is always to work as part of a team, learn more about how best to communicate in order to contribute to good nursing care. I will aim improve and develop my assertive skills when working with staff members to ensure health and safety of patients is maintained. Therefore I will make this a goal for learning in my next placement and discuss with my mentor to work out strategies for how I can achieve this. If a situation arises again like this particular one I have learned that I have also gained knowledge on the effectiveness communication How does it work out? What happens next time you are in a similar situation?

Essays --

A. A party system is the concept that political parties in a democratic country have basic similarities: they control the government, have a stable base of mass popular support, and create internal mechanisms for controlling funding, information and nominations. From 1789 to the 1890’s, the United States had three party systems. The First Party System consisted of Federalists versus Republican-Democrats (Republicans) from 1789 to 1816. This system can be considered to have developed as a result of the factions in the George Washington administration. The two factions were Alexander Hamilton and John Adams with Federalists and Thomas Jefferson and James Madison with the Republican Party. The Federalists argued for a strong national government, to push for aggressive economic development with a greater emphasis on farmers and states’ rights. They preferred to practice loose constructionism (loose interpretations of the Constitution) to argue that government power should be used to promote economic development through the creation of a national bank, federally financed roads, harbors, and bridges. Federalists believed that America’s economic future depended on the cultivation of strong commercial ties with Great Britain. The Republicans on the other hand wanted a small and weak national government to leave the citizens mostly free of taxation and government interference. Unlike the Federalists, the Republicans supported a philosophy of strict constructionism (strict interpretation of the Constitution) in order to avoid the economy benefitting only a few wealthy northeasterners. They also believed that agriculture, instead of manufacturing, should remain the country’s economic base and so they opposed closer relationships with Great B... ...e intent on preserving the interests of the common man. To do so, they favored the smaller national government and opposed, in particular, any Whig proposal that seemed to threaten their economic, social, or cultural freedoms. This period lasted until 1860. Lastly is the Third Party System from 1854 to the 1890’s consisting of the GOP and the Democrats. Beginning around the time of the start of the Civil War, this system was defined by bitter conflict and striking party differences and coalitions. These coalitions were most evidently defined by geography. The South was dominated by the Democrats who opposed the ending of slavery, and the North, with the exception of some major political machines, was dominated by the Republicans, who supported ending slavery. This era was a time of extreme industrial and economic expansion. The Third Party System lasted until 1896.

Case Study of Calyx & Corolla Essay

Calyx and Corolla is a company that can be considered a big success. It is a company that has beaten competition and has managed to curve their way into huge profits. Located in spacious offices in San Francisco gives the company added advantage as they have a centralized decision making unit. The company deals with the delivery of flowers from growers to customers by mail. This was a new invention that contributed much to the success of the company. The simplicity of their model of business was the role they played in the flowers transaction. The company only acted as a facilitator to enable growers reach customers directly. The report is an analysis of the various marketing strategies employed by the company in the course of their business and how those strategies worked. It is an evaluation of exactly how the 4Ps and 3Cs approaches were employed. It is also an evaluation of the strategies employed by the company to attract and retain customers in an otherwise flooded flower market. The paper ends with some recommendations on the future of the company particularly how to formulate a strategy to accommodate the expanded business. The paper presents the options available for the company and the capacity each option has to the company. The 4Ps model simply is a marketing strategy that strikes a balance between products, price, promotion and the place in which the business is located. On the other end the 3Cs model provide customers with choice, convenience and control to enable them enjoy the company’s products or services. Finding the right balance between all the above factors constitutes on effective marketing strategy. The companies that have managed to find this balance have managed to penetrate tight markets while competitors stagnate. A powerful marketing plan not only gains a larger share but it also gains loyalty of customers (Baker, 2003). Products are the basic units that form a company’s basis for operation. The products that a company produces have to be needed by the customers. If companies produce unnecessary goods, they would not have the means of recovering the costs involved. As entrepreneurs evaluate the businesses to engage in, they should do so based on market information. The Calyx and Corolla Company had gathered enough market data and identified customer trends. The product they chose to deal with, flowers, was one needed by customers. The company had also identified who their target segments were. In dealing with a product that expressed peoples’ emotions, the company managed to draw huge customer base (Baker, 2003).. A product can be released that customers need. But it is not until the awareness is raised that customers would gain interest in it and evaluate it with others in the market. Promotions are therefore necessary and should be targeted at the customer base the company has identified. Promotions should be centered on customer satisfaction rather than product selling. Calyx and Corolla Company run many advertisements on televisions, print media including magazines running promotions, and point of sale marketing. In their advertisements, they made customers fell that their needs had been met. They not only provided customers with flowers but they also vases to put in. The promotions covered well the entire market they intended to reach especially the European market. Customers will always go for the cheap products in the market if the utility is the same for costly ones. Customers are also willing to go for slightly costly products if they believe the goods or services are of higher quality. The business model employed by Calyx and Corolla of linking customers with flower growers enabled them to lower the costs of delivery. The company therefore offered customers cheaper products whose quality superceded that in the market. This enabled the company to gain more customers. The strategy by the company involved gaining customer royalty and expanding market share. Their price strategy worked for them evidenced by the huge sales they managed to make in just a short time. Another key factor considered for effective marketing of products is the location of the company. Location eases a company’s access to suppliers to facilitate the delivery of goods and other raw materials needed. Location is also important in enabling the company to reach their customers faster. The distributions channels of the company can only be effective if there is a central place where both suppliers and customers can operate. Calyx & Corolla Company is strategically placed in San Francisco, a place where customers hare a high demand for flowers. San Francisco is well served by the major airlines making provision of flowers and other commodities not only cheaper but also convenient. The company has spacious premises on which a warehouse has been built. The warehouse offers the company with temporally storage of products, which further reduces costs. Customers often avoid products or services that deny them the flexibility they need. They insist on having varieties to choose from. Customers are attracted more by those products that not only satisfy their immediate need but also offer more. This is the case when customers evaluate the value of the products more than the price. Calyx & Corolla Company managed to diversify their products. They not only dealt with facilitating delivery of flowers from growers to customers but also provided flower vases to the customers as a value addition strategy. The vases were offered at competitive prices, which were almost negligible for the customers. The customers were more persuaded into buying the flower vases since they had been saved the hustles of going to purchase flower vases from some other vendors. The customer care department of the calyx & corolla company was very effective in handling customer queries and complaints. The company increased workers in this department to cater for the many customers who streamed in at the peak seasons. This increased the effectiveness of the company. The company therefore succeeded in offering the necessary convenience customers sought and thus were able to move ahead of the competitors. In a company dealing with products selling or delivery as Calyx & Corolla Company dealt, customers require deals which give them power to determine what they need. As customers choose, they enjoy having control to dictate what they need. The customers in the Calyx & Corolla case, customers have control to order for certain specifications for their products. The company, by linking customers with growers, has enabled customers to identify with these growers. There are however challenges that have risen from this expansion of business. Customers have increased and complaints have increased too. The company is left with the option of hiring more workers, which in effect would be counterproductive during the low seasons. For the company to effectively compete with other international flower firms, they must consider expanding their business operations to Europe. Market research has shown that Europeans have a higher liking for flowers than the Americans. The company should therefore consider opening a branch in Europe to capture the lucrative business there.

Analysis Of Trust Management Framework - Free Essay Example

Sample details Pages: 2 Words: 540 Downloads: 5 Date added: 2019/10/30 Category Politics Essay Level High school Tags: Government Essay Did you like this example? This research proposal aims to investigate the analysis of trust management framework on cloud computing system in the Rwandan government institutions with a case study of cloud watermarking data Coloring at the Ministry of Finance and Economic Planning. Many management systems have been developed under the assumption that each Rwandan government entity has to use a variant of scoring function. Much of these framework are focusing on providing robustness and improving performance for a given community standing scheme. In a large-scale these infrastructure hosts many different functional services that are directly connected with the lives of Rwandans. Don’t waste time! Our writers will create an original "Analysis Of Trust Management Framework" essay for you Create order Specifically, services within these infrastructures should be able to deny requests from clients initiating bad transactions at one or more other services. Thus cloud computing is a one of the newest computing paradigm that provides infrastructures, platforms and software as a service in a flexible and on-demand. Nowadays the number of people that outsource their data to the cloud increases dramatically (J. Feigenbaum and J. Lacy 2016). It is estimated that cloud computing offer cost-effective dynamic, scalable and shared services for enterprises from remote data centre where these unified evaluation framework help in measuring the trustworthiness of cloud service providers. However, the problem of trusting cloud computing is a paramount concern for most enterprises in such a way that bringing security, transparency and reliability trust is widely regarded as one of the top obstacles for the adoption and growth of cloud computing specifically in the Rwandan government entities. In Rw andan computing industry there are no methods proposed either by researchers or government entities to help the consumers identify the cloud service provider who seems to be more reliable. This proposal will then provide a generic analytical of trust management framework on cloud computing system in the Rwandan government institutions, propose   security solution and therefore how to reduce the impact of any type of intrusion based on a set of assessment criteria to help cloud consumers find the trust model that best satisfies their trust concerns in cloud computing. This study will adopt a descriptive survey design. The target population of this study will be drawn from 150 staffs of the Ministry of Finance and Economic Planning. The sample size of 110 respondents will be determined using Yamanes formula. The study will use both primary and secondary data, where questionnaires, interview and annual cloud watermarking data coloring reports of MINECOFIN will be used. Primary data for the study will be collected using structured questionnaires that will be administered to the respondents. Quantitative data obtained from close ended questions will be analyzed by using d escriptive statistics. Narrative data obtained from interviews and open-ended questions in the questionnaire will be analyzed using qualitative approaches. Data collected will be analyzed through SPSS version 21. Data analysis involved statistical computations for averages, percentages, and correlation and regression analysis. Descriptive and inferential statistics and content analysis will be used for specific data. The type of validity to be used by the researcher for this study will be the content validity. For the reliability of the data collection instrument, Test- retest reliability will be used. The findings will guide the researcher after analyzing data, to observe the analysis of trust management framework on cloud computing system in the Rwandan government institutions.