Integrated Literature Review

Integrated Literature Review

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School or Institution Name (University at Place or Town, State)

Introduction

It has been witnessed that animals are being used for different medicinal purposes i.e. for developing treatments, determining toxicity of medicines, checking the safety of the products made for human use. Taking a look at history, it could be said that the use of animals in research had been started since 500 BC. In this study, various researches and experts contributed by giving their views on the use of animals as tests subjects in medical research. There are many famous scholars i.e. Aristotle and Erasistratus who used different animals and performed experiments on these living animals. The prime focus of this paper is to see is it still necessary in the present scenario to use animals in medical research and to look for means that could replace animal use in medical research. Animals used in researches is a way of protecting humans from the hazardous effects but this raises many questions on the basis of ethics (Addison,et,al,2018). Animal use in research is under criticism by animal rights and protection groups. According to the statistical analysis, annually around 115 million animals are used in medical research worldwide. Animal testing is an ongoing argument that is defended by some researches claiming that animal experimentation is a reliable way of producing sufficient useful and relevant information. This paper would include discussion on if there is any place for animal testing in medical research and what are the replacements for animal use in the testing or experimentation.

Discussion

By critically view the history, it could be said that animal testing has been playing an important role in medical and scientific research and testing of animals has been providing aid in understanding the causes and treatments for different diseases. Critical analysis of various articles has shown that there are two groups of people, one who are in favor of animal testing and second who are against it. There are various arguments, pieces of evidence and statements being given by both groups (Archibald,et,al,2019). The first group that accepts and supports animal testing in medical research claims that it is the only reliable way of testing the medicine and exploring the new ways of saving human lives. Members of this group believe that taking a risk on using animals in experiments is much better than taking a risk on humans as there is no proper alternative that researchers could use.

On the other hand, the second group believes that it is against animal rights to kill and hurt them for getting benefits for humans. According to a research by Warnock, using animals in experimentation is an ethical challenge that needs to be sorted. There is a need to find better ways rather than hurting the animals so that ethical concerns could be resolved (Gallin,et,al,2018). Scholar Dyer, in his research on animal testing, supports view being presented by Schupplui and Fraser that people should be trained for understanding the role of the community. Community could take many steps for improving the process of animal testing i.e. improving techniques of experiments and exploring new ways of testing products in medical research.

In 2010, a paper was released by the International Council for the laboratory of Animals Science that raised the point that there is a need to reconsider the process of animal testing as many ethical questions are being raised by animal rights organizations. In the past few years, the issue of animal testing became a hot button issue. So many countries are taking useful steps for saving the animals by launching many programs (Hajar,et,al,2011). For example, in Canada and Australia processes of self-regulation are being introduced through institutional AECs. According to the National statistics conducted in 2014, around 37% of animals went through severe pain, stress and discomfort and this analysis added fuel to the fire. It has been witnessed from the research conducted by many experts that it is not only the matter of the physical pain that these animals undergo rather it is much more than this.

According to Feredowisiann and Beck, the animals that are used in the experimentations and medical testing, went through many things i.e. fear, psychological distress and sadness that has been witnessed on many of the species that are used for medical testing and experimentation (Mackenzie,et,al,2018). After critically evaluating the research work and views of the above mentioned experts and research, it could be said that this fact cannot be denied that it is totally not ethical to torture any living being and hurt other non-human species for getting personal benefits. This is because it is against the rights of other living beings and the concern being raised by the committees and groups are valid when the pain of the sampled animals (animals on which experiment are performed).

Taking the views of both the groups it could be said that somehow both the groups are at the right because what they are saying is logically right. According to some of the researches, it is better to let the animals suffer than directly testing the medical and performing experimentations on humans as human life is much more precious than an animal (Bailey,et,al,2019). For resolving the issue of animal testing, it is important to search an alternative way that could be used for saving the lives of both animals and humans as it is true that without proper testing a medicine or a treatment cannot be implemented in the medical field. It is crucial to check the products it is making available for use to the general public as scientists are not sure if they are going to work or not. Studies have shown that there is not sufficient alternative available that would make it sure whether a medicine is safe or not. A scholar, Taylor claims that animal research in the daily use products and medicines has helped in developing the present market.

According to Festing, work done on animals use in medical testing, it is ethically wrong to use animals for the testing various cures and effectiveness of new medicine (Festing, et, al, 2007). He claims that both humans and animals are beings that can feel emotions and dragging them to pass through the pain is not an ethical act (Barber, et, al, 2018). One of the main concerns being raised by some researches is that pain is unique to every individual and it is impossible to say that humans and animals will have the same degree of effect if any new product is tested on them. Mackenzie claims that it is understandable that some animals are closely linked with the human systems but this cannot be said that animals being used in testing and experimentation are not always the best indicators of the reaction that humans are going to have.

Conclusion

Taking the above discussion in consideration, it could be concluded that using animals for testing and experimentation is ethical wrong, as it is unjustified to make a living being (animal)go through trauma, discomfort, stress, physiological and psychological pain. But at the same time, by taking the perspective of the other scholars who are in favour of using the animals in experimentation and testing, it could be said that somehow it is a better option to use animals for tests and experimentation. This is because they help in finding the cure and treatment of various diseases and making new products that are helping people in daily life (McGrath,et,al,2019). No risk can be taken as testing and checking of the medicines and processes being checked on animals cannot be evaluated on humans as there are multiple life risks involve. Comparing both the situations, it could be said that one of the best solutions of this problem of animals' use is to devise or explore an alternative way so that tests could be performed before allowing the medicines to be exported in the markets. There is a need to search for an alternative method that could be used but unless an alternative is not found, researchers are only left with the option of using animals in medical research for testing. From the researches, it has been proved that experimenters need to do all the things that are in their control for saving the animals from pain (Clark,et,al,2018). So, as a whole, it could be promulgated that different techniques should be used for minimizing the fear and pain of the animals being used to medical testing. New techniques should be explored and used in making the animal feel minimum pain. It is better to devise new ways and techniques regarding how animals are used in the testing, which could be avoided rather than blaming each other.

References

Addison, C., & Malone, N. (2018). An Experimental Ethics, but an Ethical Experiment? Anthropological Perspectives on Using Unproven Vaccines on Endangered Primates. The American Journal of Bioethics, 18(10), 53-55.

Archibald, K., Coleman, R., & Drake, T. (2019). Replacing animal tests to improve safety for humans. In Animal Experimentation: Working Towards a Paradigm Change (pp. 417-442). Brill.

Bailey, J., & Balls, M. (2019). Recent efforts to elucidate the scientific validity of animal-based drug tests by the pharmaceutical industry, pro-testing lobby groups, and animal welfare organisations. BMC medical ethics, 20(1), 16.

Barber, B. (2018). Research on human subjects: Problems of social control in medical experimentation. Routledge.

Clark, J. M. (2018). The 3Rs in research: a contemporary approach to replacement, reduction and refinement. British Journal of Nutrition, 120(s1), S1-S7.

Festing, S., & Wilkinson, R. (2007). The ethics of animal research. Talking Point on the use of animals in scientific research. EMBO reports 8(6), 526–530. doi:10.1038/sj.embor.7400993

Gallin, J. I. (2018). A historical perspective on clinical research. In Principles and practice of clinical research (pp. 1-15). Academic Press.

Hajar R. (2011). Animal testing and medicine. Heart views : the official journal of the Gulf Heart Association, 12(1), 42. doi:10.4103/1995-705X.81548

Mackenzie, C. (2018). Animal research: is it a necessary evil?.

McGrath, C., Fisher, R. M., Hanberg, A., Haldosen, L. A., Juth, N., & Lek, M. (2019). Getting down to the business of teaching ethics. An inter-disciplinary case study. International Journal of Ethics Education, 4(1), 23-29.

Internal Audit Of Strategic Assets

Internal Audit of Strategic Assets

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Author Note

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Internal Audit of Strategic Assets

Strategic resources in healthcare are human resources, financial resources, technological resources, and information resources. Utilizing strategic resources in an organization like healthcare can help them to reach organizational goals and development. This can also help in the minimization of risks. Strategic competencies in healthcare are communication skills, relationships with management, being a professional, knowledge and information about healthcare education, skills and knowledge about business and leadership skills.

Organizations like healthcare have been developed in the field of management and resources. They have introduced new systems in the practices starting form technologies to human behaviors. In healthcare, licensed healthcare providers can play in helping organizations to attain an advantage. Health care providers when trained enough and are made professional. It will result in better behaviors with the management and patients who can be considered as the customers. Their knowledge in the field of healthcare has an impact on the second person and the management. Their knowledge level decides their competency in healthcare ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"oEPNUZhM","properties":{"formattedCitation":"(Evans, Brown, & Baker, 2017)","plainCitation":"(Evans, Brown, & Baker, 2017)","noteIndex":0},"citationItems":[{"id":4,"uris":["http://zotero.org/users/local/smYQhi21/items/J7Y6Y9QB"],"uri":["http://zotero.org/users/local/smYQhi21/items/J7Y6Y9QB"],"itemData":{"id":4,"type":"article-journal","title":"Organizational knowledge and capabilities in healthcare: Deconstructing and integrating diverse perspectives","container-title":"SAGE Open Medicine","volume":"5","source":"PubMed Central","abstract":"Diverse concepts and bodies of work exist in the academic literature to guide research and practice on organizational knowledge and capabilities. However, these concepts have largely developed in parallel with minimal cross-fertilization, particularly in the healthcare domain. This contributes to confusion regarding conceptual boundaries and relationships, and to a lack of application of potentially useful evidence. The aim of this article is to assess three concepts associated with organizational knowledge content—intellectual capital, organizational core competencies, and dynamic capabilities—and to propose an agenda for future research. We conducted a literature review to identify and synthesize papers that apply the concepts of intellectual capital, organizational core competencies, and dynamic capabilities in healthcare settings. We explore the meaning of these concepts, summarize and critique associated healthcare research, and propose a high-level framework for conceptualizing how the concepts are related to each other. To support application of the concepts in practice, we conducted a case study of a healthcare organization. Through document review and interviews with current and former leaders, we identify and describe the organization’s intellectual capital, organizational core competencies, and dynamic capabilities. The review demonstrates that efforts to identify, understand, and improve organizational knowledge have been limited in health services research. In the literature on healthcare, we identified 38 papers on intellectual capital, 4 on core competencies, and 5 on dynamic capabilities. We link these disparate fields of inquiry by conceptualizing the three concepts as distinct, but overlapping concepts influenced by broader organizational learning and knowledge management processes. To aid healthcare researchers in studying and applying a knowledge-based view of organizational performance, we propose an agenda for future research involving longitudinal comparative case studies.","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464516/","DOI":"10.1177/2050312117712655","ISSN":"2050-3121","note":"PMID: 28620489\nPMCID: PMC5464516","title-short":"Organizational knowledge and capabilities in healthcare","journalAbbreviation":"SAGE Open Med","author":[{"family":"Evans","given":"Jenna M"},{"family":"Brown","given":"Adalsteinn"},{"family":"Baker","given":"G Ross"}],"issued":{"date-parts":[["2017",6,6]]},"accessed":{"date-parts":[["2019",10,17]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Evans, Brown, & Baker, 2017). Human capital is about the skills, knowledge, and experiences of a human and utilized by them. In the field of health care, learnings from past experiences can be helpful to avoid future mistakes and it will be helpful in the integration of skillful and information-based decisions.

A caregiver having skills and information is not only about medication but also about the use of technology, handling situations in a professional way and management skills. Having complete information and knowledge would not only help, but nurses who are trained and are being provided with a license would be able to perform better, they would be able to solve issues and tasks with quality work ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"5Tijl0lY","properties":{"formattedCitation":"(De Oliveira, 2016)","plainCitation":"(De Oliveira, 2016)","noteIndex":0},"citationItems":[{"id":8,"uris":["http://zotero.org/users/local/smYQhi21/items/U7QCRL6C"],"uri":["http://zotero.org/users/local/smYQhi21/items/U7QCRL6C"],"itemData":{"id":8,"type":"article-journal","title":"The importance of information technology as a strategic resource for hospital management process and the management skills required for managers","container-title":"International Journal of Business and Social Research","page":"34-47","volume":"6","issue":"4","author":[{"family":"De Oliveira","given":"Jayr Figueiredo"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (De Oliveira, 2016). Enhanced professional skills improve organizational achievements by assured decision making and better ways to tackle the technicalities. These strategies and competencies help organizations to attain competitive advantages in terms of quality and quantity.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY De Oliveira, J. F. (2016). The importance of information technology as a strategic resource for the hospital management process and the management skills required for managers. International Journal of Business and Social Research, 6(4), 34–47.

Evans, J. M., Brown, A., & Baker, G. R. (2017). Organizational knowledge and capabilities in healthcare: Deconstructing and integrating diverse perspectives. SAGE Open Medicine, 5. https://doi.org/10.1177/2050312117712655

KLP TASK 2: COMMUNITY OUTBREAK

KLP TASK 2: Community Outbreak

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[Institutional Affiliation(s)]

KLP TASK 2: Community Outbreak

AIDS is a disease that is caused by the virus known as HIV that stands for human immunodeficiency virus infection. Initially, a person that acquires AIDS, shows no visible symptoms and only experiences influenza-like illness. However, after the progression of infection, a person is at an increased risk of getting many common diseases because the virus directly damages the immune system (Konotey-Ahulu, 1989).

Specifically talking about the USA, AIDS found its way in the early 1960s although it was first identified when doctors discovered clusters of Kaposi’s sarcoma and pneumocystis pneumonia in gay men who were from LA and NY (Rosenberg, 1989). According to the statistics over 1.2 million people are currently living with an HIV infection. However, most concerning part is that more than 15% of people are still unaware that they have AIDS. Mostly, gay men, African Americans are more prone to this disease. In 2015 the AIDS outbreak occurred in the state of the US known as Indiana. The main reason for the spread of the diseases was due to the injection of a newly developed drug called Opana. Although it was recommended to use the drug in the form of pills it was injected intravenously. Due to lesser cases in the community, there were no specific methods to deal with any outbreak. This was a major reason that helped in the spread of a disease. After the outbreak due to government interventions, many programs such as safe needle programs were organized that provide awareness among people to prevent the diseases. Also, many health care centers were build that provide health care facilities to the people who were infected. Another approach that the government took was to put restrictions on the travel to contain the diseases in the specific area (Reif & Gong, 2014).

Similarly, in the UK many people were affected by AIDS. In the UK also most of the gay or bisexual people, Black people and other immigrants such as Latinos were highly infected by the diseases. The major outbreak that the country experienced was in 1980. During this time people were not aware of the disease and they labeled it as a “gay plague”. At this time most of the people that were diagnosed with the disease were drug users. There was no effective treatment for the people that were diagnosed with AIDS due to which the number of deaths was largely increased. After some time due to several awareness programs, people were aware of the disease and more work was done on the prevention of diseases. However, even in 2015, almost more than 1 million people were reported to have AIDS and 13% were still unaware that they have AIDS. Recently, due to government interventions, the number of people infected by the diseases is reducing. Many HIV prevention programs are running in the UK and most of the hospitals have allocated special units responsible for taking care of the people diagnosed with AIDS (Sinka & Morgan, 2003).

Epidemiology of HIV/AIDS and risk factors

AIDS is a very common disease and it is known globally. According to the statistics it is estimated that more than 36 million people were infected by HIV in 2017. However, many cases are still not reported also many people are not diagnosed with the diseases due to lack of health services accessibilities.  Although, according to the statistics most of the black Africans, Hispanics and Latinos were reported to have this disease. Also, many bisexual people are reported to have this disease (Adler, 2001). There are several modes of transmission of HIV/AIDS. They are listed below:

Drug injection:

Direct needle sharing is one of the most common ways due to which people can get infected with HIV. Even penetrating the contaminated needle in the skin is enough to transmit the diseases. Most of the drug addicts are vulnerable to get infected with HIV as they are involved in direct needle sharing. Mostly, cocaine and heroin users are above in the list of people getting infected with HIV (Lurie & Drucker, 1997). However, a health care facility is the main place where people are at a higher risk of getting infected. Many hospitals use sterilize syringes and then destroy the syringe after use however in many countries where the health care facilities are not up to date health care staff use the same syringe on a number of people. Although, most of the workers wash syringes yet the blood residue is more than enough to infect the person (Connors, 1992). As most of the people are unaware and remain undiagnosed with AIDS this direct needle sharing practice can be a potential threat to all the people that have used the same injection. Also, many hospitals have not developed a system for blood transfusion due to which many people that require urgent blood transfusion can be infected by HIV.

Sexual transmission:

This is the primary mode of transmission of HIV among people. Although the risk of getting infected by HIV after single exposure is typically low yet this factor cannot be neglected. Previously, it was considered that AIDS is a disease that occurs due to the intercourse between men however regardless of the sexual orientation of the person receptive anal intercourse is considered more dangerous and one of the reason of people getting infected (Schmiege & Bryan, 2016). Typically, females are at higher risks of getting infected by HIV (Adeboye & James, 2016).

 Perinatal transmission:

Newborns and infants are at higher risks of getting infected by AIDS if their mother or father are injection drug users. Even if the mother is not a drug user but her partner is then still a child is vulnerable to get infected with AIDS. Also, an infected mother can transmit HIV during breastfeeding as well (Prendergast & Van de Perre, 2019).

In Virginia, there are more than 21,500 people currently living with HIV. Due to which it is very important that people have awareness regarding the disease so that they can prevent themselves from getting the disease. When the AIDS epidemic was on the rise my state was also influenced by the issue. In the past, there were no separate units in the hospitals that would treat patients even there was no proper way to diagnose AIDS. People used to think that this disease only occurs in the gay community due to which people were more violent towards them. Also, during outbreak schools and offices were closed as people thought that AIDS could spread through air and food, etc. but when people came to know about the real causes they were more afraid to get the treatment from the hospitals that involved syringes. However, due to government interventions and many health care organizations are working to organize awareness programs that can help people getting information regarding this disease. The topic AIDS was also included in the curriculum of students so that they can have an idea about the disease (Swati & Sushma, 2015). Specialized care units were developed to treat people having AIDS.

After the modes of transmission of the diseases were known my state has certain laws related to HIV/AIDS. According to the law, the engagement of people having AIDS in any sexual activity is considered illegal and is punishable by up to five years in jail and fine of $2500. Also, the selling and buying of blood or organ of a person infected by AIDS are considered as class 6 felony. Additionally, all the hospitals must report the case of the person having HIV and during outbreaks, it is legal to isolate the infected people to protect the community.

 To prevent an outbreak of the disease healthcare institutions of my state have developed certain educational programs to teach people about the disease such as “assess patient’s health literacy in which the knowledge of the patient is assessed regarding the disease also people are advised to go for regular screening so that any disease can be diagnosed at early stage. Also in my community, many seminars are conducted on the community level in which the whole community participates. These seminars spread information about several diseases as well the prevention techniques that can help people prevent the disease.

References

Adeboye, A., Yongsong, Q., & James, N. (2016). Risky sexual behavior and knowledge of HIV/AIDS among high school students in Eastern Cape South Africa. Journal of Human Ecology, 53(3), 194-204.

Adler, M. W. (2001). Development of the epidemic. Bmj, 322(7296), 1226-1229.

Connors, M. M. (1992). Risk perception, risk taking and risk management among intravenous drug users: Implications for AIDS prevention. Social Science & Medicine, 34(6), 591-601.

Konotey-Ahulu, F. I. (1989). What is AIDS?.

Lurie, P., & Drucker, E. (1997). An opportunity lost: HIV infections associated with lack of a national needle-exchange programme in the USA. The Lancet, 349(9052), 604-608.

Prendergast, A. J., Goga, A. E., Waitt, C., Gessain, A., Taylor, G. P., Rollins, N., ... & Van de Perre, P. (2019). Transmission of CMV, HTLV-1, and HIV through breastmilk. The Lancet Child & Adolescent Health, 3(4), 264-273.

Reif, S. S., Whetten, K., Wilson, E. R., McAllaster, C., Pence, B. W., Legrand, S., & Gong, W. (2014). HIV/AIDS in the Southern USA: a disproportionate epidemic. AIDS care, 26(3), 351-359.

Rosenberg, C. E. (1989). What is an epidemic? AIDS in historical perspective. Daedalus, 1-17.

Schmiege, S. J., & Bryan, A. D. (2016). Heterogeneity in the relationship of substance use to risky sexual behavior among justice-involved youth: a regression mixture modeling approach. AIDS and Behavior, 20(4), 821-832.

Sinka, K., Mortimer, J., Evans, B., & Morgan, D. (2003). Impact of the HIV epidemic in sub-Saharan Africa on the pattern of HIV in the UK. Aids, 17(11), 1683-1690.

Swati, A., & Sushma, B. (2015). Knowledge, Attitude and sources of information for increasing awareness about HIV/AIDS among college students. Healthline Journal of Indian Association of Preventive and Social Medicine, 4(4), 50-7.

Market Segments

Market Segments

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[Institutional Affiliation(s)]

Author Note

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Market Segments

The United States is known for its diversified society, where people from all over the world live. The population of the United States has increased because of boomers and affordable healthcare facilities. Segmentation like Medicare enhances growth while this can be a threat to hospitals, which can put a stop on the survival of hospitals.

The healthcare industry in the United States has developed with a high growth rate. Market segments are to be followed according to the structural and infrastructural resources of hospitals to meet the demands of market segments. Medicare is that segment that is considered as the efficient use of health care services and outcomes for adults. Patients have Medicare facility or insurance tend to visit hospitals which are providing quality services, but patients without Medicare use high-quality hospitals have lower use ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9ATPcGEE","properties":{"formattedCitation":"(Popescu et al., 2017)","plainCitation":"(Popescu et al., 2017)","noteIndex":0},"citationItems":[{"id":255,"uris":["http://zotero.org/users/local/F0XOCTdk/items/QVZ69G9P"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/QVZ69G9P"],"itemData":{"id":255,"type":"article-journal","title":"Differences in use of high-quality and low-quality hospitals among working-age individuals by insurance type","container-title":"Medical care","page":"148-154","volume":"55","issue":"2","author":[{"family":"Popescu","given":"Ioana"},{"family":"Heslin","given":"Kevin C."},{"family":"Coffey","given":"Rosanna M."},{"family":"Washington","given":"Raynard E."},{"family":"Barrett","given":"Marguerite L."},{"family":"Karnell","given":"Lucy H."},{"family":"Escarce","given":"José J."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Popescu et al., 2017).

Lack of Medicare or insurance facilities has caused significant disparities in access to health care. However, the Affordable Care Act is aiming to reduce the amount of uninsured so that the maximum number of people can have access to care and health facilities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LqF5t38c","properties":{"formattedCitation":"(Scott et al., 2016)","plainCitation":"(Scott et al., 2016)","noteIndex":0},"citationItems":[{"id":256,"uris":["http://zotero.org/users/local/F0XOCTdk/items/YSJT2LLI"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/YSJT2LLI"],"itemData":{"id":256,"type":"article-journal","title":"Impact of ACA Insurance Coverage Expansion on Perforated Appendix Rates Among Young Adults","container-title":"Medical care","page":"818-826","volume":"54","issue":"9","source":"PubMed Central","abstract":"Background\nThe 2010 Dependent Coverage Provision (DCP) of the Affordable Care Act allowed young adults to remain on their parents’ health insurance plans until age 26y. While the provision improved coverage and survey-reported access to care, little is known regarding its impact on timely access for acute conditions. This study aims to assess changes in insurance coverage and perforation rates among young adults with acute appendicitis—an established metric for population-level healthcare access—after the DCP.\n\nMethods\nThe National Inpatient Sample and difference-in-differences linear regression were used to assess pre-/post-policy changes for policy-eligible young adults (19–25 year-olds) compared to a slightly older, policy-ineligible comparator group (26–34 year-olds).\n\nResults\nAfter adjustment for covariates, 19–25 year-olds experienced a 3.6-percentage-point decline in the uninsured rate after the DCP (baseline 22.5%), compared to 26–34 year-olds (p<0.001). This coincided with a 1.4-percentage-point relative decline in perforated appendix rate for 19–25 year-olds (baseline 17.5%), compared to 26–34 year-olds (p=0.023). All subgroups showed significant reductions in uninsured rates; however, statistically significant reductions in perforation rates were limited to racial/ethnic minorities, patients from lower-income communities, and patients presenting to urban teaching hospitals.\n\nConclusions\nReductions in uninsured rates among young adults after the DCP were associated with significant reductions in perforated appendix rates relative to a comparator group, suggesting that insurance expansion could lead to fewer delays in seeking and accessing care for acute conditions. Greater relative declines in perforation rates among the most at-risk subpopulations hold important implications for the use of coverage expansion to mitigate existing disparities in access to care.","DOI":"10.1097/MLR.0000000000000586","ISSN":"0025-7079","note":"PMID: 27367865\nPMCID: PMC5468100","journalAbbreviation":"Med Care","author":[{"family":"Scott","given":"John W."},{"family":"Rose","given":"John A."},{"family":"Tsai","given":"Thomas C."},{"family":"Zogg","given":"Cheryl K."},{"family":"Shrime","given":"Mark G."},{"family":"Sommers","given":"Benjamin D."},{"family":"Salim","given":"Ali"},{"family":"Haider","given":"Adil H."}],"issued":{"date-parts":[["2016",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Scott et al., 2016). Having access to the hospital would enhance and increase the in-flow of patients while they can be facilitated with quality services and facilities by the hospitals. However, more Medicare and insurance facilities can be a threat to quality services because it would not be easier to facilitate a larger population with quality services. So, an unhealthy environment and poor quality services will threat the hospitals; patients in-flow will be decreased.

Hence there is a need for strategies to maximize opportunities and minimize threats so hospitals have to provide safe and quality health services that can be afforded by a maximum number of people. This strategy will not threaten survival because this is customer attractive and encourages a relationship between hospitals and customers.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Popescu, I., Heslin, K. C., Coffey, R. M., Washington, R. E., Barrett, M. L., Karnell, L. H., & Escarce, J. J. (2017). Differences in the use of high-quality and low-quality hospitals among working-age individuals by insurance type. Medical Care, 55(2), 148–154.

Scott, J. W., Rose, J. A., Tsai, T. C., Zogg, C. K., Shrime, M. G., Sommers, B. D., … Haider, A. H. (2016). Impact of ACA Insurance Coverage Expansion on Perforated Appendix Rates Among Young Adults. Medical Care, 54(9), 818–826.

Organizational Survival Strategies

Organizational Survival Strategies

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Author Note

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Organizational Survival Strategies

Managing a business is not an easy task; it takes a lot of courage and wisdom for a businessman to run the organization and that also in such crucial times. The businessperson should have a risk-taking attitude in addition to a deep insight into the current and upcoming situations so that he or she can cope up with them in advance and design their strategies accordingly. In the current times of the rigorous competition between various organizations, every organization should know survival tactics or survival strategies. These tactics are important because of the dwindling political, social, and financial conditions in the world.

The health organizations are not safe from all these threats; they also to cope up with the dangers swirling in the market and make sure that their health care or medical facility is prospering successfully. The topmost survival tactic that health organizations should adopt is to create space for more and more patient accommodation (Jacobson, Dalton, Berson‐Grand, & Weisman, 2015). It may become a serious threat or issue for a healthcare organization if the footfall or the sick patients is more than the space available for their treatment, and an opportunity for the competitors to take advantage of this situation.

Another major survival tactic for healthcare organizations is to keep the turnover of the staff as low as possible. This survival tactic is necessary for all organizations irrespective of their area of work, however, hospitals, medical centers, and other healthcare facilities need to take special care in this regard as it may affect the health of the patients in a very serious manner. Lastly, the third and one of the most important survival tactic is to keep the medical stock up to date. The medical stock like medicines and the surgical inventory should always be available and up-to-date (unexpired products) otherwise it can cause serious harm to the patients’ health, and can even cause death.

References

Jacobson, P. D., Dalton, V. K., Berson‐Grand, J., & Weisman, C. S. (2015). Survival strategies for Michigan's health care safety net providers. Health Services Research, 40(3), 923-940.

PLANNED CHANGE APPLICATION OF A UNIT

Planned Change Application of a Unit

[Name of the Writer]

[Name of the Institution]

Planned Change Application of a Unit

Introduction

Planning for implementation of the change process consists of different steps which identify the problems with the change, the organization's mission, the model or strategy to implement, and the management of the change. Healthcare and nursing require a descriptive analysis of a difference within a unit of a healthcare organization. As for the change needed in Presbyterian Hospital Dallas, the plan is to change the fixed wooden box beds in the geriatric unit to Hill-Rom hospital beds to decrease the number of falls (Hirsbrunner et al. 2014). This plan of action or a change implementation plan would require the issue or problem identified within the department. Moreover, it would discuss the new change that can address the issue and align the organization's missions and values along with delivering a professional standard of practice. Lastly, the discussion would identify and analyze the strategy which would be facilitated to manage the change within the selected model.

Discussion

Identification

Due to an increase in the number of patients falls in the geriatrics unit, the hospital wants to make a plan for implementation of change that would change the geriatric unit. The proposal would consist of replacing the fixed wooden box beds to Hill-Rom hospital beds with a setting that may alert the nurse when the patient tries to move or fall from the bed while getting up. The problem or issue with the specific department is its lack or inadequacy to buy the latest hospital and patient equipment. Even though these Hill-Rom beds are very costly and might require extensive investment, but it would help the organization reduce the number of patient falls in the geriatrics unit. The only specific or realistic change, for now, would be to replace the wooden box beds with the Hell-Rom hospital beds. Some of the patients who fall in the geriatrics unit suffer from significant mortality and morbidity, including injuries, financial liability, and prolonged hospitalization.

Using the new plan would reduce all these issues considerably and will help the patient recover quickly. Replacing the beds with the new Hill-Rom beds is one of the admissible prevention strategies for increased patient risk. Moreover, a change in medication may also reduce the fall in elderly with special medical conditions. Nurses can also stay vigilant and active while doing their duties so that patients may require their help whenever needed. The organization’s mission is to provide quality care to patients while focusing on all other areas of nursing such as pharmacology, therapies, interventions, admission rates, recovery, etc (Wiggermann et al. 2019). All of these activities are aligned with the organization's values and mission. They aim to provide a professional standard of care to the patients while keeping the costs to a minimum. However, this change in the geriatrics unit would require extensive cost but may solve many patient-related problems.

The change model that would be required for this implementation plan would consist of a solid rationale supporting the idea of replacing the fixed wooden box beds with the Hill-Rom hospital beds. The organization would have to save its costs to buy the new beds for the patients and sell the old ones to a low minimum price. Moreover, the hospital would also have to look for credit ways to indulge towards covering its financial costs for the new plan. Other screening tools with sufficient prognostic accuracy can also be used or recommended during this plan of action. Medical records and historical records of patients having to restrain and carry risk indulgences while being cared for can be overcome during this process. This selective rationale for this change model can be adequately used. The steps for the selected change model would start with first removing the fixed wooden box beds, collecting all the funds for the new implementation plan, ordering the most useful Hill-Rom hospital beds, and putting them for patient use.

The people who would be involved in initiating and managing this change would be the ones who are directly involved with patient care. Such as doctors, nurses, therapists, hospital staff, surgeons, etc. All of these individuals would be equally involved in initiating this plan of action through properly consulting patients and involving them in the decision making process (Sligo et al. 2017). The skills and characteristics required by each individual during this change would be to have enough knowledge and expertise about the Hill-Rom hospital bed and other necessary equipment that would reduce the number of falls for patients. Moreover, the nurses would have to improve their facilitation efforts towards the geriatrics unit so that the patients can acquire as much help as they want.

Conclusion

The aforementioned plan of action and the implementation change evaluates the key theories and strategies of hospitality management and nursing. It requires the staff to manage and care for all the organizational needs adequately. As the change is extensive and requires many costs, the organization would have to evaluate all its current costs before managing to buy the Hill-Rom beds. The management would have to calculate the number of patient falls in the geriatrics unit and reflect on fixing the issues and inefficiencies found in the specific unit. While aligning organizational goals, mission, and values, the strategies should be formulated and engaged towards the units facilitation efforts. Determining what to be involved and who to be involved, the essay would reflect on the initiating and management process during the change of plan and action (Hussain et al. 2018). The characteristics and skills required by the staff for this change in process is also identified above.

References

Hirsbrunner, T., Denhaerynck, K., Fierz, K., Milisen, K., & Schwendimann, R. (2015). Nurse staffing, patient turnover and safety climate and their association with in-patient falls and injurious falls on medical acute care units: a cross-sectional study. Journal of Hospital Administration, 4(3), 54-60.

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin's change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127.

Sligo, J., Gauld, R., Roberts, V., & Villa, L. (2017). A literature review for large-scale health information system project planning, implementation and evaluation. International journal of medical informatics, 97, 86-97.

Wiggermann, N., Rempel, K., Zerhusen, R. M., Pelo, T., & Mann, N. (2019). Human-Centered Design Process for a Hospital Bed: Promoting Patient Safety and Ease of Use. Ergonomics in Design, 1064804618805570.

Promoting CQI Efforts

Promoting CQI Methods

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Promoting CQI Methods

The Institute of medicine has specified six specific aims in order to ensure the delivery along with the improvement of healthcare. These six main aims are safe, effective, patient-centered, timely, efficient and also equitable care. Safe care refers to the safety of the patients by avoiding any kind of injuries to the patient. Effective care is the scientific knowledge based care to the patients. Patient-centered care means that the standards of the patient guide the clinical decisions. Timely care is the reducing of wait for the care providers, equitable care means that the quality of the care given does not vary with gender or ethnicity of the patient. All these aims that are specified by the IOM are very important but I think that among these two of the most important aims are timely and equitable care because these two are important in the delivery of the quality care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2g3gtf7707","properties":{"formattedCitation":"(Slonim & Pollack, 2005)","plainCitation":"(Slonim & Pollack, 2005)"},"citationItems":[{"id":712,"uris":["http://zotero.org/users/local/2RJg7y7G/items/3LHPRAU5"],"uri":["http://zotero.org/users/local/2RJg7y7G/items/3LHPRAU5"],"itemData":{"id":712,"type":"article-journal","title":"Integrating the Institute of Medicine's six quality aims into pediatric critical care: relevance and applications","container-title":"Pediatric Critical Care Medicine: A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","page":"264-269","volume":"6","issue":"3","source":"PubMed","abstract":"The Institute of Medicine's report Crossing the Quality Chasm recommends \"six aims for improvement.\" The aims are safety, effectiveness, equity, timeliness, patient-centeredness, and efficiency. This review focuses on the quality of care information relevant to the Institute of Medicine's six aims to assess their relevance, potential impact, and affect on pediatric critical care practice. It is concluded that if the care for pediatric intensive care patients is to be fundamentally improved, an understanding of the current care environment, the existing evidence base, the opportunities for improvement, and the documentation of the improvements needs to be realized. The Institute of Medicine's six aims provide a useful framework to advance the quality of care in this pediatric subspecialty and perhaps others.","DOI":"10.1097/01.PCC.0000160592.87113.C6","ISSN":"1529-7535","note":"PMID: 15857522","shortTitle":"Integrating the Institute of Medicine's six quality aims into pediatric critical care","journalAbbreviation":"Pediatr Crit Care Med","language":"eng","author":[{"family":"Slonim","given":"Anthony D."},{"family":"Pollack","given":"Murray M."}],"issued":{"date-parts":[["2005",5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Slonim & Pollack, 2005).

Timely care is important because it ensures that whatever ailment or other health condition the patient has it must be treated without wasting much time. It also ensures that the patients do not wait for long in the provision of the health care facility. If timely care is given to the patients then a relationship of trust and respect is built between the patient and the healthcare provider. Hospitals or physicians can meet this aim by addressing the issues of the patient without wasting time. If for example a patient is brought to the emergency room because of an accident or suicide attempt then the hospital should first provide care to the patient instead of wasting time in unnecessary formalities only then the trust between the patient and the healthcare provider can be built ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a12fgtr16bt","properties":{"formattedCitation":"(Summit, Greiner, & Knebel, 2003)","plainCitation":"(Summit, Greiner, & Knebel, 2003)"},"citationItems":[{"id":714,"uris":["http://zotero.org/users/local/2RJg7y7G/items/4NQ6QB2C"],"uri":["http://zotero.org/users/local/2RJg7y7G/items/4NQ6QB2C"],"itemData":{"id":714,"type":"book","title":"The Core Competencies Needed for Health Care Professionals","publisher":"National Academies Press (US)","source":"www.ncbi.nlm.nih.gov","abstract":"All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.","URL":"https://www.ncbi.nlm.nih.gov/books/NBK221519/","language":"en","author":[{"family":"Summit","given":"Institute of Medicine (US) Committee on the Health Professions Education"},{"family":"Greiner","given":"Ann C."},{"family":"Knebel","given":"Elisa"}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Summit, Greiner, & Knebel, 2003)

Equitable care is also one of the most important aims for the delivery of quality care. It ensures that the quality of any health care facility does not change with the gender or ethnicity or the socio-economic status of the patient. The hospitals can meet this aim by giving proper training to their staff and also by hiring healthcare professionals and nurses from diverse cultural background and gender as well. Only then it would be possible to neglect such differences and provide healthcare facilities regardless of the gender or other factors ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"bywydggZ","properties":{"formattedCitation":"(Slonim & Pollack, 2005)","plainCitation":"(Slonim & Pollack, 2005)"},"citationItems":[{"id":712,"uris":["http://zotero.org/users/local/2RJg7y7G/items/3LHPRAU5"],"uri":["http://zotero.org/users/local/2RJg7y7G/items/3LHPRAU5"],"itemData":{"id":712,"type":"article-journal","title":"Integrating the Institute of Medicine's six quality aims into pediatric critical care: relevance and applications","container-title":"Pediatric Critical Care Medicine: A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","page":"264-269","volume":"6","issue":"3","source":"PubMed","abstract":"The Institute of Medicine's report Crossing the Quality Chasm recommends \"six aims for improvement.\" The aims are safety, effectiveness, equity, timeliness, patient-centeredness, and efficiency. This review focuses on the quality of care information relevant to the Institute of Medicine's six aims to assess their relevance, potential impact, and affect on pediatric critical care practice. It is concluded that if the care for pediatric intensive care patients is to be fundamentally improved, an understanding of the current care environment, the existing evidence base, the opportunities for improvement, and the documentation of the improvements needs to be realized. The Institute of Medicine's six aims provide a useful framework to advance the quality of care in this pediatric subspecialty and perhaps others.","DOI":"10.1097/01.PCC.0000160592.87113.C6","ISSN":"1529-7535","note":"PMID: 15857522","shortTitle":"Integrating the Institute of Medicine's six quality aims into pediatric critical care","journalAbbreviation":"Pediatr Crit Care Med","language":"eng","author":[{"family":"Slonim","given":"Anthony D."},{"family":"Pollack","given":"Murray M."}],"issued":{"date-parts":[["2005",5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Slonim & Pollack, 2005).

References

ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Slonim, A. D., & Pollack, M. M. (2005). Integrating the Institute of Medicine’s six quality aims into pediatric critical care: relevance and applications. Pediatric Critical Care Medicine: A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 6(3), 264–269.

Summit, I. of M. (US) C. on the H. P. E., Greiner, A. C., & Knebel, E. (2003). The Core Competencies Needed for Health Care Professionals.

Quantitative Analysis & Decision Making

Title page

Quantitative analysis

Methods that can be used for forecasting sales include opportunity stage forecasting, length of sales cycle forecasting and pipeline forecasting. In opportunity sales forecasting sales are estimated at different stages and it is conducted either monthly, quarterly or annually. Sales are calculated when each specific milestone is reached. Probability associated with each opportunity is calculated for determining the accurate sales CITATION Aja19 \l 1033 (Frost, 2019). Length of sales cycle forecasting is used for calculating individual opportunities and encompass different sale cycles. This method can calculate sales at least after six months. This cannot be used for quarterly estimation of sales. Pipeline forecasting another common method that calculates sales monthly or quarterly. These methods exhibit some differences and are selected according to the requirements of the organization.

The most appropriate method for given scenario is pipeline forecasting because it allow monthly estimation. This will be appropriate for predicting the sales with different marketing mix strategies.

I will choose time-series forecasting method because evidence states that it is most suitable when historical data is available. Predictions can be made on the basis of historical data about future prospects CITATION And173 \l 1033 (Jebb & Tay, 2017).

The factors that impacts the reliability of forecasts include; changes in disposable income, fluctuations in oil and gas prices. Changes in dollar prices also impact sales. Raw material costs and level of production also influence reliability of forecasts.

Time-series forecast offers a reliable measure when dollar rate are stable, there are no fluctuations in prices of oil and gas and prices of raw material also remain stable.

Time-series is currently most common and reasonable method because companies use historical data.

Time series forecast can improve by combining aggregation and clusters CITATION Tia18 \l 1033 (MendesDantas, Luiz, & Oliveira, 2018). By testing based on different techniques accuracy will be maintained.

I would select forecasting methods, their reliability and their need in businesses. I would use forecasting methods in my career for estimating sales. I would also consider how reliability can be maintained by choosing time-series data.

References

BIBLIOGRAPHY Frost, A. (2019). The Ultimate Guide to Sales Forecasting . Retrieved 11 23, 2019, from https://blog.hubspot.com/sales/sales-forecasting

Jebb, A. T., & Tay, L. (2017). Introduction to Time Series Analysis for Organizational Research: Methods for Longitudinal Analyses . Organizational Research Methods , 20 (1).

MendesDantas, T., Luiz, F., & Oliveira, C. (2018). Improving time series forecasting: An approach combining bootstrap aggregation, clusters and exponential smoothing . International Journal of Forecasting , 34 (4), 748-761 .

Quantitative Analysis & Decision Making

Name

Professor’s Name

Course Number

Date

In a world of increased demand for goods and services, humans have come up with ways to satisfy the increased population needs either for-profit or non-profit purposes. In the process of providing the best services and quality goods, an individual or a firm is faced with the need to identify the target market. This is where the aspect of data analysis comes in. Collection, analysis, and interpretation of data are important for decision making to maximize the provision of goods and services. There are two major types of data mainly qualitative and quantitative. Depending on the data collection method, one can analyze data numerically using mathematically based methods. On the other hand, qualitative data are based on people's opinions and references. How well and accurate the data collected is analyzed determines the quality of decisions made and consequently the quality of actualizations of the outcome desired.

Data is the particular statistics and facts collected for analysis. It consists of numerical quantities or qualitative details that are used to form the basis of a reason or a mathematical calculation. There are various ways data is collected. For instance, there's an observation method whereby the data is collected by observing. Interview method the data is collected through conducting a questioning session with the target group about their knowledge and opinion about the specific subject at hand. Also, there is the sampling method that involves the selection of a specific member of the population with the assumption that each member of the population has an equal probability to be selected.

Information is the details or the particulars deduced or provided about someone or something. These are facts which have been derived from certain observation and analysis of raw data. Information can be in the form of visual presentation, sound or in written form.

Knowledge is the understanding of the information at hand. Knowledge is the final product of the data analysis process. After data has been transformed into information, the people involved get an understanding of the outcome and sometimes educate relevant stakeholders to use the knowledge for the right decisions to take. Knowledge is therefore used as the guidelines for decision making.

Meaningful and correct data analysis is very vital in decision making. Pure data in itself cannot be of any relevant without the right interpretation of useful information. For instance, in a market survey scenario, only the right conclusion would lead to identifying the target market and if the data collected is interpreted correctly that means finding prospect customers and consequently increased profits. Onto the other hands, if data analysis is wrong, there would be no prospect customers for your services or goods and hence decreased profits

Ratio data is what I would use for this data analysis. This because it involves different comparisons of the four areas of sales. With ratio data, one can show the differences in profitability, sales volume, marketing expenditures, and their changes. I would incorporate the use of bar charts because it presents individual data graphically which is vivid and easy to separate the four areas with distinctive bars each showing independent quantities

To quantify the average sales of each store of the grocery chain store I would use the means sales because the mean is the average value where you add up the sales from all the scores and divide by the number of the stores available. On the contrary, the median takes into consideration only one store and disregarding the rest.

References

Introduction to Statistics(Jim Frost Ms,2013)

Social Versus Human Capital

Social versus Human Capital

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

Social versus Human Capital

Abusers have certain characteristics, which are common among most of them. They may not be alcoholic drug abusers, but they are authoritative in an indisputable way. They are antisocial by nature and their depressive tendencies negatively impact the people they surround themselves with. Furthermore, they usually alienate their partners and keep them for forming meaningful relationships with others. This not only gives them control over the situation, but it also enables them to remove their social capital from the equation ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GijzNEAB","properties":{"formattedCitation":"(Peek-Asa et al., 2005)","plainCitation":"(Peek-Asa et al., 2005)","noteIndex":0},"citationItems":[{"id":516,"uris":["http://zotero.org/users/local/0omESN17/items/D3WTN2R2"],"uri":["http://zotero.org/users/local/0omESN17/items/D3WTN2R2"],"itemData":{"id":516,"type":"article-journal","title":"A population based study of reporting patterns and characteristics of men who abuse their female partners","container-title":"Injury Prevention","page":"180-185","volume":"11","issue":"3","author":[{"family":"Peek-Asa","given":"C."},{"family":"Zwerling","given":"Craig"},{"family":"Young","given":"Tracy"},{"family":"Stromquist","given":"Ann M."},{"family":"Burmeister","given":"L. F."},{"family":"Merchant","given":"J. A."}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Peek-Asa et al., 2005).

Abusers tend to be smart in their approach, and the victim usually has no idea what is going on until it is already too late. Whether it is out of shame or pride, they no longer have anyone help them, or even seek advice on the matter. According to ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"IRo3E3C3","properties":{"formattedCitation":"(Vameghi, Akbari, Majd, Sajedi, & Sajjadi, 2018)","plainCitation":"(Vameghi, Akbari, Majd, Sajedi, & Sajjadi, 2018)","noteIndex":0},"citationItems":[{"id":517,"uris":["http://zotero.org/users/local/0omESN17/items/QH96BFB7"],"uri":["http://zotero.org/users/local/0omESN17/items/QH96BFB7"],"itemData":{"id":517,"type":"article-journal","title":"The comparison of socioeconomic status, perceived social support and mental status in women of reproductive age experiencing and not experiencing domestic violence in Iran","container-title":"Journal of injury and violence research","page":"35","volume":"10","issue":"1","author":[{"family":"Vameghi","given":"Roshanak"},{"family":"Akbari","given":"Sedigheh Amir Ali"},{"family":"Majd","given":"Hamid Alavi"},{"family":"Sajedi","given":"Firoozeh"},{"family":"Sajjadi","given":"Homeira"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} Vameghi et al., (2018) socioeconomic status of an individual takes precedence over the social capital, making the human capital all the more important. They might be at a disadvantage in terms of social capital, but human capital can. While abuse does exist on almost all social levels, a direct correlation can be observed between the lack of education, poverty and the reported abuse. By working towards the attainment of financial inequality, or by improving the educational disparity between the victim and the abuser, the victim can take the necessary steps. It can enable them to work themselves out of this vicious cycle, change their personal state and take control of the vicious situation ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VSCrvEtY","properties":{"formattedCitation":"(Crisafi & Jasinski, 2016)","plainCitation":"(Crisafi & Jasinski, 2016)","noteIndex":0},"citationItems":[{"id":518,"uris":["http://zotero.org/users/local/0omESN17/items/5HZ7NMNT"],"uri":["http://zotero.org/users/local/0omESN17/items/5HZ7NMNT"],"itemData":{"id":518,"type":"article-journal","title":"Within the bounds: The role of relocation on intimate partner violence help-seeking for immigrant and native women with histories of homelessness","container-title":"Violence against women","page":"986-1006","volume":"22","issue":"8","author":[{"family":"Crisafi","given":"Denise N."},{"family":"Jasinski","given":"Jana L."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Crisafi & Jasinski, 2016).

In a nutshell, once sufferer is able to get his feet on the ground, he can reach out to the loved ones for emotional support. The support will make them able to work towards freeing themselves from the clutches of the abuser. Social capital can help elevate the situation for the abused, but it can only go so far. You need to take the first step yourself, and only human capital can help with that.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Crisafi, D. N., & Jasinski, J. L. (2016). Within the bounds: The role of relocation on intimate partner violence help-seeking for immigrant and native women with histories of homelessness. Violence against Women, 22(8), 986–1006.

Peek-Asa, C., Zwerling, C., Young, T., Stromquist, A. M., Burmeister, L. F., & Merchant, J. A. (2005). A population based study of reporting patterns and characteristics of men who abuse their female partners. Injury Prevention, 11(3), 180–185.

Vameghi, R., Akbari, S. A. A., Majd, H. A., Sajedi, F., & Sajjadi, H. (2018). The comparison of socioeconomic status, perceived social support and mental status in women of reproductive age experiencing and not experiencing domestic violence in Iran. Journal of Injury and Violence Research, 10(1), 35.

Starte Regulation

Title page

State regulation

Hello Marine,

I agree with your views about the significance of nursing regulations and how they are actually working in your two selected states; Kentucky and Connecticut. I agree that APRN have acquired different statuses in the state of Kentucky such as midwife, clinical specialist and anesthetist. I agree that regulations play important role in promoting overall health of the patients by highlighting the requirements of practicing which allow only certified nurses to practice CITATION Nic15 \l 1033 (Blazek, 2015). I think that one of the most significant regulation of the Kentucky and Connecticut states is that the nurse must have background in nursing. They must possess certification program that assure that only competent nurses will be addressing the patients.

I agree with the post that the regulations of Illinois are effective for providing adequate care. This also minimizes the risks of unqualified nurses attending the patients. I agree that the regulations for APRN are encouraging them to develop nursing skills and acquire all qualifications that are crucial for joining the clinics or healthcare institutes. The nurse needs to prove her competency before getting a certificate for practice CITATION EMc14 \l 1033 (McCleery, Christensen, Peterson, Humphrey, & Helfand, 2014).

I believe that one of the significant advantages of these state regulations is minimization of medication errors. When hospitals will hire more capable and qualified nurses, fewer incidents will be reported about the medication errors or mismanagement. There are common regulations in Kentucky and Connecticut because both require that the nurse must obtain certification before becoming a practicing nurse. They can also prescribe controlled substances by following the instructions and guidelines of the state regulations. I agree that implementation of strict regulations have improved the quality of care and satisfaction of the patients.

References

BIBLIOGRAPHY Coventry, L. L., Pickles, S., Sin, M., Towell, A., Giles, M., Murray, K., et al. (2017). Impact of the Orthopaedic Nurse Practitioner role on acute hospital length of stay and cost‐savings for patients with hip fracture: A retrospective cohort study. JAN , 731 (11).

Been-Dahmen, J. M., Hazes, J. D., Staa, A., & Ista, E. (2015). Nurses' views on patient self-management: a qualitative study. . J Adv Nurs , 71 (12), 2834-45.

Blazek, N. (2015). NPs important leaders for evidence-based practice, improving patient outcomes. NAPNAP .

McCleery, E., Christensen, V., Peterson, K., Humphrey, L., & Helfand, M. (2014). Evidence Brief: The Quality of Care Provided by Advanced Practice Nurses. . PubMed .

Philpot, C., Tolson, D., & Morley, J. E. (2013). Advanced practice nurses and attending physicians: a collaboration to improve quality of care in the nursing home. ournal of the American Medical Directors Associtaion .

Strategic Thinking

Strategic thinking in hospitals

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Strategic thinking in hospitals

In the health care arena, many organizations are working to help and treat people. Organizations nursing staff, doctors, management and administration are working for a sustainable health sector. Proper strategic thinking and planning leads the hospitals to identify opportunities for the development and competition in the health care industry

Hospitals in the health sector can be considered as a complex service because of their activities, multiple objectives, professional diversity and nature of work. Hospitals are not only limited to surgeries or medicines, but they also offer many services like nursing care, imaging, and visual health checkups. Strategic thinking is the art of managers which shows the creativity and perceptions of their particular environment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"3eaz5b6L","properties":{"formattedCitation":"(Nahid, Habib, Taghi, Akbar, & Hassan, 2016)","plainCitation":"(Nahid, Habib, Taghi, Akbar, & Hassan, 2016)","noteIndex":0},"citationItems":[{"id":83,"uris":["http://zotero.org/users/local/smYQhi21/items/6ITBYB3C"],"uri":["http://zotero.org/users/local/smYQhi21/items/6ITBYB3C"],"itemData":{"id":83,"type":"article-journal","title":"THE RELATIONSHIP BETWEEN STRATEGIC THINKING AND READINESS TO CHANGE AMONG MANAGERS OF SOCIAL SECURITY HOSPITALS IN ISFAHAN, IRAN","page":"114-119","volume":"13","issue":"248","source":"www.sid.ir","abstract":"Download Free Full-Text of an article THE RELATIONSHIP BETWEEN STRATEGIC THINKING AND READINESS TO CHANGE AMONG MANAGERS OF SOCIAL SECURITY HOSPITALS IN ISFAHAN, IRAN","language":"En","author":[{"family":"Nahid","given":"Jamali"},{"family":"Habib","given":"Danayi"},{"family":"Taghi","given":"Amini Mohammad"},{"family":"Akbar","given":"Hassanzadeh"},{"family":"Hassan","given":"Emami Seyyed Mohammad"}],"issued":{"date-parts":[["2016",1,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nahid, Habib, Taghi, Akbar, & Hassan, 2016). Strategic thinking in hospitals is to develop such plans which would satisfy the patients, and workers by meeting their concerns.

Organizations expand their working sectors according to the resources available, this can create maximum opportunities. So, expanding services means to provide opportunities with the help of strategic thinking and planning. Organizations like hospitals achieve organizational objectives to get prepared to compete in the industry by making changes within the organization and develop to create resources. However maximum resources mean maximum opportunities for individuals and facilities for the staff, and patients.

Hospitals can compete in the industry by showing flexibility towards change and strategic thinking enables the organization to create adopt such plans, and actions that would be supportive of the achievement of goals. Hospitals with strategic thinking translate the aims, objectives, and goals into efficient visions, and missions ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"dd5YPUi4","properties":{"formattedCitation":"(Ginter, Duncan, & Swayne, 2018)","plainCitation":"(Ginter, Duncan, & Swayne, 2018)","noteIndex":0},"citationItems":[{"id":86,"uris":["http://zotero.org/users/local/smYQhi21/items/QTJAXH7P"],"uri":["http://zotero.org/users/local/smYQhi21/items/QTJAXH7P"],"itemData":{"id":86,"type":"book","title":"The Strategic Management of Health Care Organizations","publisher":"John Wiley & Sons","number-of-pages":"528","source":"Google Books","abstract":"A comprehensive guide to effective strategic management of health care organizations. Strategic Management of Health Care Organizations provides essential guidance for leading health care organizations through strategic management. This structured approach to strategic management examines the processes of strategic thinking, consensus building and documentation of that thinking into a strategic plan, and creating and maintaining strategic momentum – all essential for coping with the rapidly evolving health care industry. Strategic Management of Health Care Organizations fully explains how strategic managers must become strategic thinkers with the ability to evaluate a changing industry, analyze data, question assumptions, and develop new ideas. The book guides readers through the strategic planning process demonstrating how to incorporate strategic thinking and create and document a clear and coherent plan of action. In addition, the all-important processes of creating and maintaining the strategic momentum of the organization are fully described. Finally, the text demonstrates how strategic managers in carrying out the strategic plan, must evaluate its success, learn more about what works, and incorporate new strategic thinking into operations and subsequent planning. This strategic management approach has become the de facto standard for health care management as leadership and strategic management are more critical than ever in coping with an industry in flux. This book provides heath care management students as well as health care administrators with foundational guidance on strategic management concepts and practices, tailored to the unique needs of the health care industry. Included are a clear discussion of health services external analysis, organizational internal analysis, the development of directional strategies, strategy alternative identification and evaluation, and the development and management of implementation strategies providing an informative and insightful resource for anyone in the field. This new eighth edition has been fully updated to reflect new insights into strategic thinking, new methods to conceptualize and document critical environmental issues, practical steps for carrying out each of the strategic management processes, industry and management essentials for strategic thinkers , and new case studies for applying the strategic management processes. More specifically, readers of this edition will be able to: Create a process for developing a strategic plan for a health care organization. Map and analyze external issues, trends, and events in the general environment, the health care system, and the service area. Conduct a comprehensive service area competitor analysis. Perform an internal analysis and determine the competitive advantages and competitive disadvantages. Develop directional strategies. Identify strategic alternatives and make rational strategic decisions for a health care organization. Develop a comprehensive strategy for a health care organization. Create effective value-adding service delivery and support strategies. Translate service delivery and support plans into specific action plans. The health care industry’s revolutionary change remains ongoing and organizational success depends on leadership. Strategic management has become the single clearest manifestation of effective leadership of health care organizations and the strategic management framework’s strengths are needed now more than ever. The Strategic Management of Health Care Organizations provides comprehensive guidance and up-to-date practices to help leaders keep their organizations on track.","ISBN":"978-1-119-34970-9","note":"Google-Books-ID: 3qVFDwAAQBAJ","language":"en","author":[{"family":"Ginter","given":"Peter M."},{"family":"Duncan","given":"W. Jack"},{"family":"Swayne","given":"Linda E."}],"issued":{"date-parts":[["2018",2,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ginter, Duncan, & Swayne, 2018). So, developing strategic thinking in hospitals is to make them able to adopt the new trends and accept the challenges. Strategic thinking in organizations like hospitals helps to improve efficiency, so when hospitals are working efficiently it means that they are competing with other organizations.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The Strategic Management of Health Care Organizations. John Wiley & Sons.

Nahid, J., Habib, D., Taghi, A. M., Akbar, H., & Hassan, E. S. M. (2016). The Relationship Between Strategic Thinking And Readiness To Change Among Managers Of Social Security Hospitals in Isfahan, Iran. 13(248), 114–119.

Pascuci, L. M., Meyer Júnior, V., Crubellate, J. M., Pascuci, L. M., Meyer Júnior, V., & Crubellate, J. M. (2017). Strategic Management in Hospitals: Tensions between the Managerial and Institutional Lens. BAR - Brazilian Administration Review, 14(2). https://doi.org/10.1590/1807-7692bar2017160092

The Challenge Of Change

The Challenge of Change

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

The Challenge of Change

It is said that “Change is the only constant thing”, and stands to be very true. Change is inevitable, no matter what area it is, change is going to come and no one can avoid it. Most of the time, change cannot be stopped or even controlled, only the strategies can be devised or moulded according to this change. Whether it’s a change in nature or geography due to some natural cause or some man-made cause, precautionary measures can be taken during the process of change or after the change.

If a particular scenario of the business is considered, there are a number of instances where change proves to be beneficial for the organization. Especially in the case of healthcare organizations, change proves to be very effective and helpful as it is intended for the betterment of the patients (Fullan, 2009). A positive change in the area of health care affects millions positively.

Managing change in the sector of healthcare and nursing has never been an easy task, in fact, is a very complex and challenging phase. This dynamic process is never a choice between technological or people-oriented solutions; however, it is a combination of all the factors. An effective change in the area of healthcare as unfreezing old behaviors, introducing new behaviors and re-freezing them.

Employees usually show reluctance in accepting the change but managers are usually motivated to bring in the change. Change in the area of healthcare and medicine may be continuous, rare, occasional sporadic or continuous. Most of the times changes are unpredictable, and the strategies usually are designed after the change has taken place. The examples of successful changes in the area of healthcare are the induction of technology and the computerized record-keeping of the details or medical records of the patients.

References

Fullan, M. (2009). The challenge of change: Start school improvement now!. Corwin Press.

Understanding Quality

Understanding Quality

[Name of the Writer]

[Name of the Institution]

Understanding Quality

Harris Health Care

The Harris Health Care is a society-owned HealthCare system that is committed to provide high quality and exceptional, cost-effective, compassionate health care services to the community/residents regardless of their financial capabilities.

Aspects of Quality Policy

The quality policy of health care provider has been developed for the purpose to monitor and improve services quality, patients’ safety, and overall performance.

The included terms in the policy are;

Quality and Safety

Provide high quality and safe services with no compromise on eliminating harms to patients from care which is intended to help them. As well as for providing high-quality healthcare services to every citizen organization have skilled, knowledgeable, and well-trained staff and employees (Harris Health System, 2019).

Time Efficiency

To reduce the waiting for patients and even all visitors. As well as to avoid all harmful delays for all who are involved in taking care or providing care. As well as quality policy include prompt and friendly services and safe & comfortable environment which is highly sensitive and fully responsive to the needs and concerns of patients (Parker, Ratzan, & Lurie, 2013).

Efficiency

The main purpose of the quality policy is to avoid wastage that can be wastage of equipment, supplies, items, energy and even ideas.

Equitability

The policy includes the terms of equitability which mean that care services does not and would not differ in quality due to personal characteristics such as sex, ethnicity, geographic, demographics, economic status or other characters of someone.

Patient-Centered

The policy is fully concerned about ensuring the provision of care services to the community that is respectful of and highly responsive to preferences, needs, and values of individual patients (Connor, Trinh, & Shewchuk, 2010). As well as to ensure that every individual and patient values guide every clinical decision.

Based on the things and aspects, the Quality Policy of Harris Health Care Services is an effective and well-established policy that cover all aspects. But! Some minor terms have been excluded from the policy. The terms have been excluded on the basis ISO 9001 standards because those terms were not fully applied to the organization in some ways. The terms which are excluded are;

Processes of the Pharmaceutical Quality System

The Harris Health Care has excluded the Pharmaceutical Quality System Process because most and even all activities and pharmaceutics do not apply to the organization such as purchasing medicines, goods-in, and testing in some particular areas (Connor, Trinh, & Shewchuk, 2010).

Design and Development of New Methods

Harris Health Care System utilizes only the proven approaches, ways, methods, medications and other equipment. The health care service provided does not participate in the designing and development of new ways and methods, treatments, and/or medications (Harris Health System, 2019).

Financial Growth and Financial Concerns

Being a health care service provider, concentrating on revenue generation is not the ultimate goals of Harris Health Care. So the organization has excluded the terms of financial growth and concerns. This has been excluded for the purpose to meet all standards of QMS.

Quality Policy and Organization’s Areas

The quality policy of every organization affects even all organizational aspects and areas. These areas are mostly and usually affected positively by the quality policy of the organizations. The quality policy of Harris Health Care affects the following areas of health care service provider.

Management

Management is one of the most crucial areas of organization of every level. The Quality Policy affects management in more than a single way. The management is concerned to cater every issue occur in or outside the organization that has impacts on the health care services of Harris Health Care. Beyond that, management’s responsibility to improve the processes, operations, retained skills and capabilities, and ensure high-quality services with no compromise on anything. So, the quality policy of Harris Health Care affects management in the way that management should oversee the extreme quality, performance, safety programs of health care. This is done for the purpose to develop and maintain best and highly convenient services, patients’ satisfaction, and patient & staff safety (Grol, Baker, & Moss, 2012).

Communication and Reporting

Communication and Reporting are the initials to patients’ safety and performance improvement. Number of communications and reporting exist to keep staff and leadership informed about every happening. Hence, the policy affects this area by recommending for monitoring for every input and output of the quality management system. The policy force communication of Harris Health Care overcome every communication barrier because of which the issues in performance improvement and patients’ safety are raised (Grol, Baker, & Moss, 2012). While reporting has been affected in the way that it should evaluate organization from every perspective and identify needs and improvements for better services and operations.

Reasons for Policy Creation

There are several reasons because of which the Harris Health Care has created this quality policy. But! Some of the major reasons are as follows;

The policy fully expresses the commitment of management to ensure quality care services that lead to patient well-being and satisfaction.

The policy has been created because it is highly important because it is the basis for quality services, communication and overall performance of the organization.

In order to monitor quality control and quality assurance systems and other related standards, the policy has been created (Parker, Ratzan, & Lurie, 2013).

This policy is highly commensurate with the organizational model and objectives of Harris Health Care.

Beyond above, this policy has been created because it helps organization to save costs and eliminate extra expenses in many ways. Increase patients’ satisfaction, improve service offerings, and reduce waiting and responsive timings. The policy fully meets the requirements and standards of QMS (Quality Management Systems) through the concept of patents centered and equitability and efficiency, so the policy has been created because of these matters too.

References

Connor, S. J., Trinh, H. Q., & Shewchuk, R. M. (2010). Perceptual gaps in understanding patient expectations for health care service quality. Health care management review, 25(2), 7-23.

Grol, R., Baker, R., & Moss, F. (2012). Quality improvement research: understanding the science of change in health care.

Harris Health System. (2019). Quality Manual 2016. Media.bcm.edu. Retrieved 16 August 2019, from https://media.bcm.edu/documents/2017/da/harris-health-system-quality-manual-2016.pdf

Parker, R. M., Ratzan, S. C., & Lurie, N. (2013). Health literacy: a policy challenge for advancing high-quality health care. Health affairs, 22(4), 147-153.

Understanding The Scope Of Vulnerable Populations

Understanding The Scope Of Vulnerable Populations

[Name of the Writer]

[Name of the Institution]

Understanding The Scope Of Vulnerable Populations

Vulnerable Mothers and Children

Pregnancy can be marked as high-risk vulnerability due to different factors. Unhealthy weight, insufficient use of medication, lack of nutrition, use of tobacco and alcohol, and domestic violence can bear unwanted implications on the unborn child and the mother (Koblinsky, Campbell & Harlow, 2018). For these reasons, pregnant women are considered a vulnerable population. Vulnerable mothers' lack of access to adequate healthcare has a direct relation to infant mortality (Koblinsky, Campbell & Harlow, 2018). In 2006, 83.2% of pregnant women seeking health care during pregnancy. Although the infant mortality rate in the United State is on a decline with 5.98 infant deaths recorded for per 1000 births, still there are racial and ethnic groups that have higher infant mortality rates than the US nationals. For instance, due to low income and inadequate income and social status have increased infant mortality in these groups.

Chronically Ill and Disabled People

Chronic diseases attribute to 70% of US deaths annually. In 2005, 26.6% of deaths were due to heart diseases. 53% of the deaths were due to chronic lower respiratory diseases. and diabetes caused 3.1% of the deaths. Chronic diseases often result in permanent physical impairment. 32.5% of people over 65 years of age were rendered disabled due to chronic diseases. 7.3% of adults became physically disabled due to diseases. although the chronic disease is linked with personal choices. These choices can be smoking cigarette that could result in lung cancer and respiratory diseases that would increase the risk for this population.

People Diagnosed with HIV/AIDS

The deaths related to HIV/AIDS are on the rise since the 1980s. There were nearly 500,000 people in the United States tested positive for HIV/AIDS in the year 2008. In 2011, this number decline to 200,000 with 50,000 new patients each year. Although all American populations are vulnerable to HIV/AIDS, African American homosexual and bisexual men are at increased risk to contract the disease (McAteer et.al, 2016). 61% of the total HIV patients belonged to the said social strata. The pain and suffering of HIV/AIDS are further exacerbated by the stigma around it (McAteer et.al, 2016).

Conclusion

Vulnerable Populations

Three HealthCare Needs

Vulnerable Mothers and Children

Affordability of services for pregnant women, acceptability in the society for single pregnant women, and accommodation for the homeless pregnant women

People with Chronic Diseases

Anti Depression Therapy, Provision of Assistance with movement, Provision of effective chronic care management

People afflicted with HIV/AIDS

Reducing the stigma revolving around HIV/AIDs, widespread coverage and access to prevention services, effective follow up for HIV prevention

References

Koblinsky, M. A., Campbell, O. M., & Harlow, S. D. (2018). Mother and more: a broader perspective on women’s health. In The Health Of Women (pp. 33-62). Routledge.

McAteer, C. I., Truong, N. A. T., Aluoch, J., Deathe, A. R., Nyandiko, W. M., Marete, I., & Vreeman, R. C. (2016). A systematic review of measures of HIV/AIDS stigma in paediatric HIV‐infected and HIV‐affected populations. Journal of the International AIDS Society, 19(1), 21204.

"Social Ecological Model (SEM) Worksheet"

Social Ecological Model (SEM) Worksheet

Complete each section of the table below.

Social-Ecological Model: Framework of Prevention Activities

Identify the health problem: Substance abuse

Identify the target population affected by the health problem: The youths

Level of Influence

Factors That Contribute to the Health Problem (Risk Factors)

Evidence –Based Prevention Strategies by Level of Influence

Individual

Biological and personal history factors that put someone at risk for a health condition. Prevention strategies address attitudes, beliefs, and behaviors.

Depression and Attention Deficit Hyperactivity Disorder (ADHD).

Mental illness is also a risk factor for adolescent substance abuse

Medical checkup and early treatment for adolescents with mental issues.

Physiological support to youths undergoing depression due to different issues.

Relationship

Close relationships such as social circle-peers, partners, and family members who influence behavior that may increase the risk for a health condition. Prevention strategies promote healthy relationships, mentoring, skill building.

Peer influence from friends and people around.

Ignorance on the effects of substance abuse.

Failure of parents to restrict children from taking drugs.

Educating the youths on the risks of substance abuse.

Encouraging guardians to monitor their children and also make them understand the risks of substance abuse.

Community

Settings such as schools, workplaces, and neighborhoods where social relationships occur and seek to identify characteristics of these settings associated with a health condition. Prevention strategies impact the social and physical environment to support positive behavior change or prevention of the health condition.

Lack of rules and regulations to guard against all form of drug abuse.

Culture of the community also might lure most youths into the use of drugs.

Peer influence.

Encourage managers or heads of various settings on the need of creating regulations that would prevent members from using drugs.

Encouraging better morals that would definitely form part of the culture.

Societal

Broad societal factors, such as social and cultural norms, socioeconomic policies, or health disparities, which help create a climate for a health condition. Prevention strategies target changes in those factors such as changing social norms and changing policies to support health.

Social status also makes youths get engaged in substance abuse.

Lack of jobs also makes youths to become desperate and depressed and they end up using drugs.

Poor leadership, like having leaders who fully depend on substance abuse.

Supporting poor families by supporting their children get education and learn much on the effects of substance abuse.

Creating jobs for the youths to remove all sorts of idleness that might enhance substance abuse.

Encouraging adults to acts responsibly in order to set a good example to the younger generation.

Adapted from:

Centers for Disease Control and Prevention. (n.d.) The social-ecological model: A framework for violence prevention. Retrieved from

https://www.cdc.gov/violenceprevention/pdf/sem_framewrk-a.pdf

(Evidence-Based Practice Beliefs And Behaviors Of Nurses Providing Cancer Pain Management: A Mixed-Methods Approach)

Evidence-Based Practice Beliefs and Behaviors of Nurses Providing Cancer Pain Management

(A Mixed-Methods Approach)

[Author’s name]

Miami Regional College

MSN 5300: Advanced Nursing Inquiry and Evidence-Based Practice

Evidence-Based Practice Beliefs and Behaviors of Nurses Providing Cancer Pain Management

(A Mixed-Methods Approach)

Introduction

Ethics in research provides proper norms of conduct for all the stakeholders to differentiate between the acceptable and unacceptable line of action ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"O6ZooAVO","properties":{"formattedCitation":"(Resnik, 2018)","plainCitation":"(Resnik, 2018)","noteIndex":0},"citationItems":[{"id":"w2OUz1EJ/4dSXfAhD","uris":["http://zotero.org/users/local/7Hi3kAOD/items/WNKXMTIZ"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/WNKXMTIZ"],"itemData":{"id":1187,"type":"book","title":"The Ethics of Research with Human Subjects: Protecting People, Advancing Science, Promoting Trust","publisher":"Springer International Publishing","URL":"https://books.google.com.pk/books?id=uQdGDwAAQBAJ","ISBN":"978-3-319-68756-8","author":[{"family":"Resnik","given":"D. B."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Resnik, 2018). The main objective of considering research ethics is to provide instructions for conducting responsible research. In other words, it ensures the monitoring of researchers during the entire procedure of research according to high ethical standards. Principles of ethics are used as the roadmap by the researcher to ensure the element of morality in the research process. There are many reasons that define the importance of ethics in the field of research. First, ethical norms assist researchers to promote the actual objective of the research study that appeared in the form of delivery of the truth. Second, the consideration of the ethics in the research procedure helps people to develop better forms of cooperation and trust. Protection of human rights, the advancement of scientific research, and the promotion of trust are recognized as the three major aims relevant to the practical form of ethical research. Here the focus is to critically analyze the study, “Evidence-Based practice Beliefs and Behaviors of Nurse Providing Cancer Pain Management: A Mixed-Methods Approach” to identify the prospect of ethical principles.

Research Study Overview

The considered research study was conducted by Eaton et al. in 2015 in order to enhance the approach of research work in the field of healthcare and nursing. Exploration of the actual aim of the research work is important to critically analyze the effectiveness of this research work. The purpose of the research work is to critically illustrate the evidence-based practice (EBP) beliefs and behaviors of nurses specifically in the context of cancer pain management. Selection of appropriate research design is critical to ensure the reliability of the research outcomes. The health concern in case of clinical decision making is addressed by the researchers by focusing on the practical aspects of evidence-based practice (EBP). Undoubtedly, it is crucial to how evidence-based practices can be helpful when it comes to pain cancer management in the clinical setting.

A detailed evaluation of the research article revealed that the mixed-methods approach was adopted by the researchers to adopt both the perspectives of quantitative and qualitative research work. Adoption of the mixed-method research approach helped researchers to observe the phenomenon of evidence-based practice (EBP) considering the functioning approach of two inpatient oncology units ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0Gyq3Dac","properties":{"formattedCitation":"(Eaton, Meins, Mitchell, Voss, & Doorenbos, 2015)","plainCitation":"(Eaton, Meins, Mitchell, Voss, & Doorenbos, 2015)","noteIndex":0},"citationItems":[{"id":2015,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/B3H7BR72"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/B3H7BR72"],"itemData":{"id":2015,"type":"paper-conference","title":"Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: A mixed-methods approach","container-title":"Oncology nursing forum","publisher":"NIH Public Access","page":"165","volume":"42","author":[{"family":"Eaton","given":"Linda H."},{"family":"Meins","given":"Alexa R."},{"family":"Mitchell","given":"Pamela H."},{"family":"Voss","given":"Joachim"},{"family":"Doorenbos","given":"Ardith Z."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Eaton, Meins, Mitchell, Voss, & Doorenbos, 2015). Descriptive and cross-sectional methods of data collection were adopted by researchers to find out the actual trend of EBP in case of cancer pain management.

The sample size for this research study is limited to 40 registered nurses to assess the practical domains of the main idea of EBP. Particular nurses were selected for the research study who directly responsible to provide direct care to the patients who were dealing with cancer pain. Consideration of the sample size of the study helps to figure out the general application of the outcomes of the research. When it comes to the stage of data collection, then the practical strategies of interviews and web-based surveys were adopted by the researchers to attain feedback from the respondents. Identification of the main research variables of the study is important to examine the actual theme of this piece of research. EBP beliefs, EBP implementation, evidence-based pain management are the main variables of the research study. The main purpose of the inclusion of these variables is to examine the practical nursing approach adopted by registered nurses specifically in the form of evidence-based practice.

Critical evaluation of the results of the research study is also imperative to assess the actual application of the idea of EBP. The findings of the study revealed that nurses agreed to the positive implications of EBP with the consideration of implementation ability. The outcomes of the study also indicate that overall implementation level was low in the case of EBP. It was observed by the researchers that maximum nurses were satisfied with their performance level considering pain management practices. The fundamental themes of the main topic are recognized as the limited definition of EBP, varied evidence-based pain management decision making, limited identification of evidence-based pain management practices, and the integration of nonpharmacologic intervention into the domain of patient care. Exploration of the themes of the research study assists to establish that it is feasible to apply the outcomes in case of the clinical practical domain. The outcomes can be useful for the nursing staff in the process of providing better healthcare services to cancer patients through the adoption of appropriate evidence-based practices. Identification of actual reasons for the low level of EBP implementation by nurses specifically in case of pain management further helps to explore the better ways of healthcare services in clinical nursing practices.

The results of the study revealed some practical measures in the form of implications for the department of nursing. It is established that EBP beliefs and behaviors of nurses need to be considered in case of developing strategies for the sustaining evidence-based pain management practices. A critical assessment of the practical implications of this study on financial grounds is also important to examine the actual suitability of the concept of EBP in case of clinical healthcare services. This research study is ranked as an applied study from a financial aspect as researchers conducted practical research work by conducting the process of research. They used different methods of data collection to attain the response of the sample of the study. The content analysis of the responses explicitly indicated the practical form of the study.

Ethical Issues in Research

The process of research can never rank as complete without considering the aspect of ethics. In other words, ethics is characterized as the one important standard to define the success of the research work. The researcher needs to consider the importance of ethics when it comes to the implications of different phases of the research work. At the first stage, it is crucial for the researcher to figure out the concept of ethical research and determine its importance in the case of research. Understanding of the ethical standards in research eventually assists the researcher to consider ethical issues that might prevail during the process of research. Timely identification of the ethical issues is the only solution to attain the desired form of ethical research.

Detailed understanding of the historical grounds of the research work eventually reveals the risk factors in case of improper approach of ethics. It is imperative for the researcher to critically examine the former research studies on the issue to better figure out the ethical issues that might happen in the case of the research process. The origin of the concept of ethics belongs to the ancient Greek philosophical method of inquiry. This particular method illustrated the basic principles of ethics that provided clear directions for the actions of human beings according to moral conduct. Ethics established as the crucial dynamic of the entire process of decision making concerning the perspectives of right and wrong ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"tYVqas8p","properties":{"formattedCitation":"(Jenn, 2006)","plainCitation":"(Jenn, 2006)","noteIndex":0},"citationItems":[{"id":2016,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/9H4HTBFR"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/9H4HTBFR"],"itemData":{"id":2016,"type":"article-journal","title":"Common ethical issues in research and publication","container-title":"Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia","page":"74","volume":"1","issue":"2-3","author":[{"family":"Jenn","given":"Ng Chirk"}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Jenn, 2006). The prospect of ethics and moral conduct gain importance in the case of human experimentation over the years due to the growing concern of human errors and ethical concerns.

It is revealed that increasing rate of human exploitations in case of research process encourage to ensure the application of principles of ethics in researcher. This main aim of this form of consideration is to minimize the risk of human biasedness in the research process and ensure proper dealing of ethical issues in research. The major ethical issues in case of research particularly linked with the prospects of informed consent, beneficence, confidentiality, privacy, and the approach of vulnerable groups of people ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"RA2oD44A","properties":{"formattedCitation":"(Silverman, 2016)","plainCitation":"(Silverman, 2016)","noteIndex":0},"citationItems":[{"id":2017,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/FYJWH32Q"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/FYJWH32Q"],"itemData":{"id":2017,"type":"book","title":"Qualitative research","publisher":"Sage","ISBN":"1-4739-8484-X","author":[{"family":"Silverman","given":"David"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Silverman, 2016). It is essential for the researcher to critically consider all these perspectives when it comes to adopting a true perspective of ethics in research. A brief explanation of all these major issues of ethics in research is important to establish the required form of the research process.

Informed consent is established as the mandatory aspect in research to assure the appropriate form of ethical standards. It is a major ethical issue for the researcher to attain proper consent from the respondents when it comes to using their information in the research process or consider them as part of the research. Right of autonomy of each respondent needs to be protected considering the principle of ethics in the form of informed consent. The ethical principle of beneficence indicates that there is a need for assurance of protection of all shareholders during the entire procedure of research work. Harming anyone during the process of research is not permitted when it comes to the assurance of ethical research. Confidentiality is another major aspect that exists in the case of ethical research considering the major principles of the conduct of ethics. It is critical for the researcher to protect the dignity and security of all the respondents during the research procedure and never reveals their personal information for any cause other than research work. Privacy is another critical ethical issue closely linked with the domain of confidentiality of the respondents. It is one basic criteria in research to achieve the objective of ethical research. Another major issue that prevails in case of research is consideration of vulnerable groups in the research procedure. Undoubtedly, it is one tricky prospect for the researcher to make a decision about the inclusion of vulnerable group in research. The researcher needs to be highly vigilant to effectively handle all the major ethical issues in case of the research process.

Protection of Human Rights

Human rights protection is one major agenda of the ethical research that is concerned with the proper consideration of five major principles of ethics. Active involvement of all the principles of ethics is vital to attain the desirable form of human rights during the process of research. Protection of human subjects should be the priority for the researcher to avoid the ethical issues in the case of research work. Comprehensive understanding of the approach of ethical research reveals that there are five prominent aspects in case of human rights that must be protected during the entire process of research work ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Jj4Dq10V","properties":{"formattedCitation":"(Amon, Baral, Beyrer, & Kass, 2012)","plainCitation":"(Amon, Baral, Beyrer, & Kass, 2012)","noteIndex":0},"citationItems":[{"id":2018,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/HB3BIUCT"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/HB3BIUCT"],"itemData":{"id":2018,"type":"article-journal","title":"Human rights research and ethics review: protecting individuals or protecting the state?","container-title":"PLoS medicine","page":"e1001325","volume":"9","issue":"10","author":[{"family":"Amon","given":"Joseph J."},{"family":"Baral","given":"Stefan D."},{"family":"Beyrer","given":"Chris"},{"family":"Kass","given":"Nancy"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Amon, Baral, Beyrer, & Kass, 2012). Identification of these features of human rights protection ultimately provides a roadmap of research procedure to the researcher.

Exploration of five elements of human rights protection is possible through the critical consideration of five basic principles of research ethics. Informed consent, beneficence, confidentiality, privacy, consideration of the people of vulnerable groups are ranked as the basic features of human rights that need to be protected by the research during the whole process of research work. Proper explanation of all these aspects of human rights protection is helpful domain to achieve the actual objective of human right protection in case of ethical research work. Informed consent is a major step to ensure the proper protection of human rights in the process of research. It is mandatory for the researcher to attain prior permission from all the respondents to ensure their participation in the research process. Self-determination and comfort level of all the shareholders is utmost critical that can never be violated at any cost. Adoption of the principle of ethics in the form of beneficence is also significant that indicate that harming any individual for the sake of research is not an option for the researcher. Assuring physical, psychological, and emotional protection is one of the crucial practical ethical principles of the research work.

Protection of confidentiality of the respondents is another important form of the protection of human rights in case of research work. Researchers are restricted to never share personal information of any respondent without permission. The human right of privacy is closely linked with the practical domain of confidentiality of the respondents in case of the research process. The privacy of human beings can never be violated in any form during the research process. The approach of a vulnerable group of people is another major feature of consideration when it comes to the protection of human rights in case of ethical research. Researchers need to be careful when it comes to the inclusion of vulnerable people as the sample for the research work. It is necessary for the researchers to develop proper guidelines for the vulnerable group of people who might not able to protect their rights.

It is vital to examine how these factors of human rights protection are present specifically in the case of the research study of evidence-based practice beliefs and behaviors of nurses in the provision of cancer pain management. A detailed evaluation of this research study clearly indicates that researchers religiously focus to ensure the standards of human rights protection. The entire procedure of research work was approved by the University of Washington Institutional Review Board. The approval of the study is the clear indication of the appropriate consideration of human rights protection by the researchers. It is clearly mentioned in the study that the ethical principle of informed consent is adopted by the researchers to ensure the willingness of registered nurses who are considered as the potential sample for the study. It is observed that all the potential participants provided their consent for the approach of study participation. Personal information of the participants was gathered by the researchers to identify the nurses’ perspective about the approach of EBP. Attainment of the personal information of all the respondents made it essential for the researchers to ensure the protection of human rights particularly in the forms of confidentiality and the privacy of the nurses.

Sampling Method

Selection of the appropriate sampling method is established as one of the critical aspects of the entire research process. Researchers need to be critical when it comes to adoption of sampling technique according to the actual requirements of the research procedure. A detailed evaluation of different steps of the research work helps to indicate the selected sampling method and its implications on the results of the study. A descriptive, cross-sectional, mixed-methods design of sampling is used by the researchers to collect the responses from the respondents. The sampling approach of mixed-method design permits researchers to attain both forms of qualitative and quantitative research work. A mixed method of sampling ultimately made it easy for the researchers to utilize different methods of data collection for this particular study. 40 registered nurses were selected by inviting them to participate in the study.

It is important to comprehensively analyze both forms of qualitative and quantitative sampling established by authors for this study. This form of understanding further help to examine the effectiveness of the sampling methods selected by the researchers. The technique of questionnaires is used by the researchers in the form of a quantitative method of sampling. Different scales of demographic questionnaire, the EBP Beliefs Scale, The EBP Implementation Scale, and Carlson’s Prior Conditions Instruments. Survey data for this study were gathered from 44 RNs who considered as the sample. Consideration of diverse instruments for the data collection helped researchers to find out the exact responses from the sample according to the actual requirements of this study. Qualitative method of data collection was also used by the researchers to obtain proper responses. The practical technique of individual semi-structured interviews was offered by the researchers to the participants when it comes to sharing their perceptions about the approach of EBP. It is critical to indicate that registered nurses were selected as the sample for this study by considering their interactive role in case of EBP. The level of interaction of registered nurses in the scenario of EBP was established by the researchers as the standard to choose the subjects for participation in this study.

Thorough understanding of the sampling approach of this study revealed that the method of simple random sampling was used by the researchers to attain required responses from the registered nurses. This specific approach of sampling gives equal chance to each registered nurse belongs to EBP to become part of the sample for this study. This particular technique of sampling method established as the one appropriate method to avoid the issue of biasedness. The effectiveness of this specific method can only check by considering the implications of other methods of sampling. There are many other methods of sampling that were the options for the researchers to conduct this particular research work. The implications of the sampling method in the form of simple random sampling clearly indicate that it was the most suitable method for the study which was considered by the researchers. This specific method of data collection allows each member to have an equal chance to become part of the sample of the study. Consideration of the random selection of registered nurses eventually positively influence the domain of outcomes by ensuring unbiased results.

Assessment of the sampling method on ethical grounds is also important to ensure the prevalence of ethical research. The sampling method established by the researchers clearly indicates that principles of ethics were considered by the researchers. Equal chances for each registered nurse in the context of EBP illustrated about the fair process of sampling adopted by the researchers. The population in question in case of this particular research study can never rank as a vulnerable population as registered nurses have complete authority to deliver their consent for the study.

Informed Consent

It is notable to mention that taking informed consent for participants is necessary for any research purpose in order to avoid any enforcement actions. Informed consent is a voluntary agreement which ensures that participants are willing to join a research project ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GDz5tqiE","properties":{"formattedCitation":"(Grady, 2015)","plainCitation":"(Grady, 2015)","noteIndex":0},"citationItems":[{"id":2021,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/79MFFEXP"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/79MFFEXP"],"itemData":{"id":2021,"type":"article-journal","title":"Enduring and emerging challenges of informed consent","container-title":"New England Journal of Medicine","page":"855-862","volume":"372","issue":"9","author":[{"family":"Grady","given":"Christine"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Grady, 2015). It is considered as an essential aspect of any research before procedures and treatments. Informed consent contains essential information about research and its risks. In the considered research article, 12 nurses participated in an individual semi-structured interview. The basic purpose of this research study is to understand the perception of nurses towards evidence-based practice regarding pain management of cancer. Informed consent was shared with all twelve nurses who participated in this research study to avoid any legal action in the future.

The documentation of evidence-based pain management in the patient medical record is identified through the nurses’ interview. In order to fulfil the paradigm of informed consent, nurses were provided with the necessary information about this research study. It is notable to mention that risks regarding this research study were also discussed with participated nurses. The informed consent for this research study was detailed as it contains information about the purpose of the study, the rights of participates regarding this study, the procedures to be undergone with during the entire interview and the potential risks of participation. It is notable to mention that the legal rights of participated nurses were not waived. The consent was obtained properly in this research study as participated nurses were told about the benefits and risks of their participation. It was made clear with these nurses that their participation is solely dependent on their willingness to join the research study. Sufficient information was provided to the participated nurses, so they had adequate time to make an informed decision about their participation in this research project. The informed consent was taken from the participated nurses through an online web survey method. Participated nurses were told about the duration of this interview in advance so they can manage their time accordingly to avoid any inconvenience later. The duration of the interview ranged from 30 to 45 minutes which was notified in the online consent form.

It is essential to mention that two nurses did not participate in this research study as they were unable to manage sufficient time for a digital interview. Permission for the digital interview was taken from the nurses in order to understand their perception about evidence-based practice in terms of cancer’s pain management. Informed consent is an ethical conduct of human subject’s research. The individual autonomy is completely respected in this research study which ensures that the fundamental ethical principle of the consent is followed in this research study. Each individual is independent of his/her thought and decision in regard to anything. In the considered research study, participated nurses were also given the individual autonomy to decide whether they want to participate in the given research study or not. The voluntary consent of the individual is of utmost importance to ensure the safety and protection of subject along with the integrity of the research study. Furthermore, the interview of each nurse was individually recorded along with consent. Detailed consideration of every precise information was added in the given informed consent. The purpose of the research along with involved procedures was included in the consent. The benefits of the research study were included in the consent along with all foreseeable discomforts and risks to the subject. The consent also includes the length of time expected from participants to contribute their time for this research study. Moreover, the consent also included a statement that any participant can use his/her right to withdraw from the research study without any penalties. The informed consent needs to be detailed and precise about the entire research study and the participation of individuals. Registered nurses were provided with this detailed consent form which contains a clause of every aspect of human rights, human welfare, their right to leave this research study whenever they want, along with positive aspects of the research study.

The consent also included information about the number of subjects that are participating in this research study. The original idea was to include 44 registered nurses in this research study in order to increase the overall size of subjects to get more liable information. Unfortunately, two of these registered nurses refused to join this research study due to busy work schedule. The researchers were unable to change the number of a subject participating in this research study as it was already delivered with nominated registered nurses. However, each registered nurse was notified about the number of actual participants in this research study during the digital interview. One of the important and major considerations of informed consent is the use of non-technical language. It is recommended by the institutional review board to use simple language that is understandable to the participants of any research study. Technological or medical terms need to be explained in lay terms or they should be defined properly so that participants can understand it. In the considered research study, online consent documentation was written in simple, non-technical language so it easily met the expectations of registered nurses. All the medical terms were clearly defined in the informed consent documents to ensure that nurses completely understood its meaning. It is highly important to make the consent documents in the language of the participants to avoid any ambiguity. The consent documentation was prepared in the native language of participated registered nurses. IRB highly recommend not to use exculpatory language in the consent documents whether oral or written. It is noteworthy to mention that the consent documents of considered research study did not include any exculpatory language.

Ethical Scientific Integrity

Development of the significant approach of ethical scientific integrity is also necessary to attain the desirable form of ethical research. The concept of ethical scientific integrity helps to assess the involvement of researchers during the process of research. The principles of scientific integrity recognized as the guideline to determine the appropriate role of the researchers. It is vital to attain information about the contribution of the researchers in the field of research to figure out the truthfulness of their research work. Professional integrity demands researchers to truthfully implement all the stages of the research and present the truth to the world. The criteria of the scientific integrity of the researcher can be used to make better inferences about the actual reliability of the research work. Professional integrity for the field of research demands researcher to describe all the knowledge in the most truthful manner.

The broad idea of scientific integrity comprised of two basic standards that established as the fundamental guidelines for the professional researchers. Firstly, it is important for the researchers to contribute to the paradigm of research by enhancing the overall culture of integrity during the whole procedure of research. The second principle of research integrity is related to the feature of evidence-based policy interests. It is necessary for the researchers to play their role in a legitimate manner by avoiding unnecessary interference in the entire process of research ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MoBmVG5l","properties":{"formattedCitation":"(Breault, 2006)","plainCitation":"(Breault, 2006)","noteIndex":0},"citationItems":[{"id":2020,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/JIH3L9TL"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/JIH3L9TL"],"itemData":{"id":2020,"type":"article-journal","title":"Protecting human research subjects: The past defines the future","container-title":"Ochsner Journal","page":"15-20","volume":"6","issue":"1","author":[{"family":"Breault","given":"Joseph L."}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Breault, 2006). Transparency in the scenario of research is the one core objective of the spectrum of research that needs to be completed by the researcher to achieve the desired form of ethical scientific integrity.

Detailed consideration of credentials of all the researchers is mandatory, who play a critical role in conducting the research on the topic of EBP in the context of cancer pain management. Identification of the designation of each research will help to figure out the authenticity of the research study. Linda H. Eaton is the prestigious name in the field of healthcare nursing, who is performing her role project director in the School of Nursing at the University of Washington. Alexa R. Meins also have an important role in the entire process of this research study. She is the student of PhD degree, who is focus to successfully adopt the approach of research and utilize it to attain valuable knowledge for the field of nursing. The rest of the authors of this research study also working at reputable working positions as professors in the School of Nursing at the University of Washington in Seattle. Proper consideration of the credentials of the researchers of this research work ultimately helps to determine the potential scientific integrity of this piece of research work. The information about the careers of the authors helps to establish the seriousness and the truthfulness that involves the entire procedure of the research work.

The authors of this research study also provide additional information that is helpful to assess the reliability and durability of this research work. It is indicated that this research study was supported by different legal and reputed healthcare institutions of the country. These particular organizations are established with the names of American Cancer Society, the ONS Foundation, and the University of Washington. Furthermore, the role of the National Institute of Nursing Research can also never ignore who awarded this research study. Deep consideration of the ethical grounds of the research study also demands to evaluate the options of data fabrication or inappropriate use of important information. It is observed that the illegal and unethical option of data fabrication was not used by the researchers as an option. Researchers followed each step of the research procedure and present the results they attained from the procedure of research work. All the required data from the respondents is collected by the researchers through the systematic steps and analyze this information through the statistical methods. Describing each step of the research process for the study ensures that fair and ethical means were used by the researchers to identify the trend of EBP in case of cancer pain management. Secondary sources were also correctly used by the researchers by giving credits to the original authors in the forms of proper citations and references. Plagiarism is recognized as another major aspect to characterize the ethical scientific integrity adopted by the researchers in case of the research study. The concept of plagiarism is defined as using any form of knowledge without giving proper credit to the author of that content. It is established that all the secondary information used by authors in this research study was properly referenced and there is no evidence of unethical inclusion of data in the study.

IRB

IRB is known as an institutional review board, which is an administrative body. It is notable to mention that each social research study needs to be approved and protected by an administrative body. An administrative body ensures that the rights of participants are protected to participate in research activities. It is essential to mention that IRB is a highly reputable administrative body which protects the rights and welfare of participants in a case study. The considered research study was approved by the Institutional Review Board of the University of Washington. The IRB of the University of Washington ensured the protection of participated nurses in this research study. Prior to the initiation of any research study, IRB usually reviews the entire procedure of human participants. It is notable to mention that IRB is charged with the protection of involved participants in any research study. In the considered research study, IRB ensured that individual autonomy of participated nurses is respected. Nurses were given full autonomy in their decision to join this research study. IRB of the University of Washington reviewed ethical and legal consideration regarding this research. It is necessary to mention that the consideration of ethical and legal aspects are of utmost importance to avoid any disciplinary action in the future. Furthermore, institutional, scientific, and social implications are a prominent factor for any institutional review board to ensure the integrity of a research study in terms of federal regulations and institutional policy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kVNzDbDb","properties":{"formattedCitation":"(Nurunnabi, 2014)","plainCitation":"(Nurunnabi, 2014)","noteIndex":0},"citationItems":[{"id":2019,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/DBEX9W8J"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/DBEX9W8J"],"itemData":{"id":2019,"type":"article-journal","title":"Institutional Review Board (IRB): its role and responsibility in making research ethical","container-title":"Bangladesh Journal of Bioethics","page":"5-10","volume":"5","issue":"1","author":[{"family":"Nurunnabi","given":"Abu Sadat Mohammad"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nurunnabi, 2014) . Reviewing potential objects of the research study in terms of human participation provides a precise idea about the preference of this research towards participants.

Confidentiality is an important and serious aspect which protects participants in terms of their right to privacy. Every individual has the right to privacy and breaching such right often results in serious enforcement action by law enforcement agencies. Institutional review board ensured that the paradigm of confidentiality is completely fulfilled in this research study. In the considered research study, all personal data of participated nurses kept safe and secure from any outside person. Moreover, the IRB ensured that the process of consent is completely met during this research study.

The entire process of online consent was reviewed by IRB of the University of Washington. They ensured that online consent contained all information including benefits and potential risks of this research study. Thorough information of research study was added in the online consent form to confirm that participants are well aware of the implication of this research study. Researchers of this research study made an approval letter for their research to be approved by the institutional review board of the University of Washington. The approval letter contained all necessary information about this research study including the participation of voluntary nurses. The researchers ensured that the right to privacy and human rights are not violated in this research study. The ethical and legal factors were included in this research approval letter for IRB. The IRB thoroughly reviewed each aspect of this research study, with great emphasis on the protection of participants’ rights and their welfare throughout the research study. Furthermore, institutional review board highly recommends using simple language for informed consent so that participants can easily understand any research study. Use of exculpatory language is needed to avoided as per IRB as it can create certain ambiguities.

HIPAA

HIPAA is a federal law that sets national standards in order to safeguard personal health information and medical records. It is notable to mention that HIPAA privacy rule is designed to protect collected data and personal information in medical records ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ZUhiLaQm","properties":{"formattedCitation":"(Arora, Yttri, & Nilsen, 2014)","plainCitation":"(Arora, Yttri, & Nilsen, 2014)","noteIndex":0},"citationItems":[{"id":2023,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/48FLJIAJ"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/48FLJIAJ"],"itemData":{"id":2023,"type":"article-journal","title":"Privacy and security in mobile health (mHealth) research","container-title":"Alcohol research: current reviews","page":"143","volume":"36","issue":"1","author":[{"family":"Arora","given":"Shifali"},{"family":"Yttri","given":"Jennifer"},{"family":"Nilsen","given":"Wendy"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Arora, Yttri, & Nilsen, 2014). This information is protected through Health Insurance Profitability and Accountability Act. Personal medical information is stored as per the national standard of HIPAA in all offices of doctors and hospitals. It is critical to mention that the individual has complete autonomy to review his/her medical record at any time. Each person has the right to review his/her medical information when needed and he/she can request to change any information if it is not correct.

In the considered research study, the information of registered nurses was not taken from the medical database. There was no need to take medical information from HIPAA, as all the required information was taken through interview. It is notable to mention that there was no need for using database information about registered nurses as it does not deal in depth with their medical history or information. The research study was made to understand the perception of registered nurses regarding evidence-based practices in terms of cancer pain management. Registered nurses were supposed to provide their perspective in this regard to ensure their understanding of the topic. That was the main reason to not use medical information of registered nurses from the database to complete the research study. However, critical actions were taken to ensure the safety of their personal information, which was taken during the interview. The information of registered nurses was protected with the help of assigned numbers in place of their names. They were referred to as registered nurses throughout the research study to protect their personal information such as name and history.

The benefit to Risk Ratio

The benefit to risk ratio is another effective practical measure to achieve the better outcomes of the research study. It is important to assess the research work under the standard of the risk ratio to figure out the actual implications of the research study. A risk ratio is defined as the ratio that is used to determine the actual risk of an action considering the potential benefits ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MBIe4jP8","properties":{"formattedCitation":"(Chenail, 2011)","plainCitation":"(Chenail, 2011)","noteIndex":0},"citationItems":[{"id":2022,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/UNSLGJBQ"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/UNSLGJBQ"],"itemData":{"id":2022,"type":"article-journal","title":"Interviewing the investigator: Strategies for addressing instrumentation and researcher bias concerns in qualitative research","container-title":"The qualitative report","page":"255-262","volume":"16","issue":"1","author":[{"family":"Chenail","given":"Ronald J."}],"issued":{"date-parts":[["2011"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chenail, 2011). The analysis of the risk-benefit ratio is used by the analyst to correctly quantify the actual risks and benefits in the form of their ratios. Critical analysis of the entire risk can be helpful to figure out the actual effectiveness of the action. The concept of benefit to risk ratio can also use in case of research procedure to figure out the actual opportunities and the risks of the entire research process. It is recommended for the researchers to measure both forms of risks and benefits at the first stage of the research to evaluate the actual effectiveness of the research study. This form of evaluation can be helpful to attain the right track of the research procedure and achieve beneficial outcomes from the entire action of research. The approach of the ratio can be helpful for the researcher to assess the overall feasibility of the research work considering both the perspectives of potential risks and benefits.

There is no evidence that researchers utilized the option of benefit to risk ratio in case of the research study on the topic of EBP specifically in the context of cancer pain management. The risk ratio was not calculated by the researchers to identify the potential risks and opportunities in the form of a ratio. It is established by former research studies that risk ratio is ranked as a suitable method to attain the correct form of estimation. The comprehensive overview of IRB closely linked with the practical domain of the benefit to risk ratio. The outcomes of this particular research study can rank as an effective contribution in the field of nursing when it comes to the approach of EBP. The evaluations of this study can positively impact the individuals and the whole community as it involves the healthcare perspective. The perspectives delivered by the registered nurses in this study can further use to enhance the approach of EBP specifically in case of cancer pain management.

Conclusion

In a nutshell, it is worthy to mention that the research study on the issue of EBP in the context of cancer pain management is effective to form of research work for the nurses. The outcomes of this study can further use to improve the practical domains of the main idea of evidence-based practice in the context of the functioning of registered nurses. The assessment of the research study on ethical grounds is also important to establish the moral standards of the research. Proper application of different principles of ethics in research helps to ensure the desired approach of human rights protection at every stage of the research procedure. A critical assessment of each step of this research study reveals that the standards of ethics are greatly followed by the researchers. Approval of this research study from IRB is the major evidence to define this as the ethical form of research work.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Amon, J. J., Baral, S. D., Beyrer, C., & Kass, N. (2012). Human rights research and ethics review: protecting individuals or protecting the state? PLoS Medicine, 9(10), e1001325.

Arora, S., Yttri, J., & Nilsen, W. (2014). Privacy and security in mobile health (mHealth) research. Alcohol Research: Current Reviews, 36(1), 143.

Breault, J. L. (2006). Protecting human research subjects: The past defines the future. Ochsner Journal, 6(1), 15–20.

Chenail, R. J. (2011). Interviewing the investigator: Strategies for addressing instrumentation and researcher bias concerns in qualitative research. The Qualitative Report, 16(1), 255–262.

Eaton, L. H., Meins, A. R., Mitchell, P. H., Voss, J., & Doorenbos, A. Z. (2015). Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: A mixed-methods approach. Oncology Nursing Forum, 42, 165. NIH Public Access.

Grady, C. (2015). Enduring and emerging challenges of informed consent. New England Journal of Medicine, 372(9), 855–862.

Jenn, N. C. (2006). Common ethical issues in research and publication. Malaysian Family Physician: The Official Journal of the Academy of Family Physicians of Malaysia, 1(2–3), 74.

Nurunnabi, A. S. M. (2014). Institutional Review Board (IRB): its role and responsibility in making research ethical. Bangladesh Journal of Bioethics, 5(1), 5–10.

Resnik, D. B. (2018). The Ethics of Research with Human Subjects: Protecting People, Advancing Science, Promoting Trust. Retrieved from https://books.google.com.pk/books?id=uQdGDwAAQBAJ

Silverman, D. (2016). Qualitative research. Sage.

11 Blue Men

11 Blue Men

Your Name

Institution

11 Blue Men Worksheet

Question 1

The first victim was identified on Monday at 8 am and was taken to an emergency room. The second victim was brought in the same emergency room at 10:25 am. Similarly, the next three victims were brought to the emergency room at 11:05 am in the same ambulance. Sixth and Seventh victims were brought in the emergency room and 11:20 am. Eight and ninth victims were brought in at 11:35 am while the tenth victim arrived at 12:00 pm. The last victim arrived at the emergency room at 6:45 pm.

Timeline of these eleven victims is important information for epidemiologists so that they can determine what could have caused the disease. Moreover, this information is also helpful to epidemiologist to understand the incubation of the illness or disease.

Question 2

As the name of incident 11 blue men, the fingers of the victims brought into an emergency room were turned sky blue. More common symptoms of illness in these eleven victims were abdominal pain and ears, lips and nose turned blue. After a certain period of time, the blueness spread throughout their bodies with an incubation period of 30 to 120 minutes. In addition, victims were in a severe state of shock and become unconscious.

Question 3

The first step in investigating the illness is to interview the victims. Victims will be asked several questions to understand why this phenomenon is occurring as soon as they gain consciousness. There were 11 people who became the victim of some strange illness on the same day, with same symptoms and illness. This strange pattern of symptoms in eleven patients raises the need for epidemiologist CITATION RAG90 \l 1033 (RA Goodman, 1990). Blood samples of each victim have been taken to detect if there any foreign element present in their blood which may have caused the disease. The link between these victim has been found to be some restaurant in which these victim has dined in. Sodium nitrate has been found in the sample and later on it was found that the restaurant has cooked their oatmeal in sodium nitrate. The illnesses of elven blue men were due to excess of sodium nitrate in their body. Excessive sodium nitrate intake is poisonous for a human being CITATION Hil99 \l 1033 (Hill, 1999).

Question 4

Three questions that have been asked by Dr. Greenberg and Dr. Pellitteri are; Do you have any history of health problems, what meal did you have last, and at which restaurant did you have the meal at?

These questions have helped Dr. Greenberg and Dr. Pellitteri in identifying the cause of illness. Similarity found in the investigation helped the doctors in identifying the cause of the illness is the restaurant from which the victims all have eaten from.

Question 5

Three questions asked by epidemiologist are

What are the key ingredients of oatmeal been cooked in the cafeteria?

How long does it take to sell the batch of oatmeal?

How often oatmeal is cooked in the cafeteria?

The first question helped epidemiologist in identifying sodium nitrate is the cause of illness of eleven blue men. Next two questions were to know if the oatmeal is fresh and how many people have eaten the oatmeal from the restaurant.

Question 6

The final culprit which has been found in the investigation of epidemiologist was sodium nitrate. Sodium nitrate was identified when a result of the salt sample from oatmeal has arrived. After the test, it was found that the salt which has been used in cooking and the salt that elven men used both contained sodium nitrate. Excessive intake of sodium nitrate has caused the illness of eleven men CITATION Hil99 \l 1033 (Hill, 1999).

Question 7

The elven were affected more as compared to other people because they have added more salt to their oatmeal while eating it. Adding more salt has increased the presence of oatmeal and the oatmeal had become poisonous for the victims CITATION Hil99 \l 1033 (Hill, 1999).

References

BIBLIOGRAPHY Hill, M. (1999). Nitrate toxicity: myth or reality? British Journal of Nutrition. Retrieved from https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/nitrate-toxicity-myth-or-reality/485C9FB213AE2539A44AABA4D42A0380

RA Goodman, J. B. (1990). The epidemiologic field investigation: science and judgment in public health practice. American journal of Epidemiology. Retrieved from https://academic.oup.com/aje/article-abstract/132/1/9/77979

2 Page Reaction To Man’s Search For Meaning

Man’s search for meaning

[Name of the Writer]

[Name of the Institution]

Book Review

The book, “Man’s search for meaning” by Viktor Frankl is termed and noted as one of the books that have brought huge differences and upheavals in the lives of its readers. The book is said to be “The classic tribute to hope from the Holocaust”. In this book, Viktor writes about his survival in the death camps of Nazi by saying that life is not always about the despair and devastation that is the product of Holocaust but of hope that is the product of atrocity. The book is divided into two parts where one part is the expression of life at camp while other part explains the form of psychology that the author practices (Frankl, 1985). The author shared the story of his life when he was a slave to Dachau and Auschwitz camps representing survival. Frankl shared the example of the psychology of prisoner, how he views jail and what are his hopes for getting the freedom to live on his own (Frankl, 1985). In the other part of the book, the author shared his ideology about the therapeutic philosophy which was used from both dimensions spiritual and philosophic to address human experiences (Frankl, 1985).

As during that time, Sigmund’s approach was dominant, Frankl reviewed the Freudian approach and termed it as one of the harshest approaches that have reduced the mental life of human being to a random element that lack the vision to address existential meaning. Frankl imparts a positive motivation to his life rather than secondary rationalization of the instinctual drives. Frankl named this approach as Logotherapy, a technique that could be used to address the idea proposed by Sigmund Freud. However, the coined termed referred to the meaning of human existence accompanied by the ability and attitude of an individual to know himself (Frankl, 1985).

In the book, Frankl has identified and proposed three major human capabilities also called noological possibilities named as, self-transcendence, self-detachment, and ability to spiritually stay in touch with something and being independent on someone that is independent of spatiotemporal dimensions. In other words, the connotation refers to the idea that humans are not able to avoid suffering but they have the ability to retrieve meaning from it. Frankl has identified three primary postulates that were found to complement these capabilities each with a specific stance. The first postulate is anthropological postulate that infers human existence in terms of critical thought to past present and future. The second postulate is termed as a psychological postulate that is supposed to address the motivation of an individual while searching for the meaning.

According to Frankl, this procedure can only be fulfilled by the individual if it is to be satisfying. The third postulate is also called philosophical postulate that deciphers Frankl’s life during the time of the Holocaust. This postulate directs that there is no traditional meaning of the life for which Frankl has quoted several examples (Frankl, 1985). Moreover, Frankl made some discussion on the integration of logotherapy in some psychotherapeutic practices. He proposed several limitations and interventions of the therapy from some qualitative perspectives. Other theorists such as Abraham Maslow and Stanislav Grof are of those therapists that took his work very seriously. It would not be wrong to say that the book has itself become one of the most influential books in America that is an always available source of motivation and encouragement for people. The book not only endures the hellish conditions and the unwanted life scene of the author but it is also a unique approach to psychology that addresses the notion and passage of making meaning for life by overcoming the disparities(Frankl, 1985).

References

Frankl, V. E. (1985). Man's search for meaning. Simon and Schuster.