Poetic Inspiration in Kubla Khan and Rime of the Ancient Mariner Essay

Poetic Inspiration in Kubla Khan and Rime of the Ancient Mariner      Ã‚  Ã‚   An examination of the characters that Coleridge presents in "The Rime of the Ancient Mariner" and "Kubla Khan" and the situations in which they find themselves reveals interesting aspects of Coleridge's own character that are both similar to and different from the characters named in the titles of these poems. In particular, an examination of these characters with an eye toward Coleridge's conception of poetic inspiration and success can be fruitful.    In "Kubla Khan," Coleridge depicts a powerful character who "did ... a stately pleasure dome decree" ("Kubla Khan" lines 1-2). The fact that Kubla Khan is able merely to decree a pleasure-dome and know that his orders will be executed implies that he is a character of both strong will and great creative power. This faith in himself is not misplaced. The Khan decrees that a pleasure-dome be built and his order is immediately executed: "So twice five miles of fertile ground/ With walls and towers were girdled round" (6-7). Some aspects of the landscape and the dome echo the hardness implied by the chieftain's single-minded determination: the fountain "with ceaseless turmoil seething," the "dancing rocks" that are tossed into the air by the fountain, the "ancestral voices prophesying war," and the fact that the sacred river itself is "flung up momently" by the fountain (18, 23, 30, 24). As the Khan's creation, the dome can reasonably be expected to contain clues to his character, and th e characterization of the Khan harmonizes well with these clues about his character given by the pleasure dome: the image of a Mongol chief is one associated with danger, war, and a large amount of strength.    ... ... of a broken and essentially conciliatory force. When seen in these terms, it seems that the mariner may be the image with which Coleridge most closely identified himself, but both are symbols of his creative process.    References The Bible. Authorized (King James) Translation. Coleridge, Samuel Taylor. "Kubla Khan" in Samuel Taylor Coleridge: A Critical Edition of the Major Works. Ed. H J. Jackson. Oxford: Oxford University Press, 1985. Coleridge, Samuel Taylor. "The Rime of the Ancyent Marinere, in Seven Parts" (1798 text) in Romanticism: An Anthology, Second Edition. Ed. Duncan Wu. Oxford: Blackwell Publishers Ltd., 1998. Coleridge, Samuel Taylor. "The Rime of the Ancient Mariner. In Seven Parts" (1817 text) in Samuel Taylor Coleridge: A Critical Edition of the Major Works. Ed. H J. Jackson. Oxford: Oxford University Press, 1985.   

Free King Lear Essays: The Unaccommodated Man :: free essay writer

The Unaccommodated Man in King Lear In William Shakespeare's King Lear, betrayal is a common event that leads to the downfall of some of the characters. In today's society, there are two main attitudes that are generally taken towards these fallen individuals or unaccommodated men. The first attitude is more of a pessimistic, judgmental attitude. This attitude puts the majority of the blame on the individuals themselves. The individuals are portrayed as being responsible either due to ignorance or laziness, and it is thought that the individuals got themselves into their deprived situation and they can also find their way out. The second view is more optimistic and is usually more merciful and accepting. People taking this stance generally would take pity on the individuals thinking that their unfortunate situation was due to a simple case of bad luck, or that these individuals were taken advantage of or betrayed by others ultimately leaving them accommodated. In King Lear, the characters Lear, Gloucester, and E dgar were all betrayed by family members leading to their unaccommodated lives. Once again you can take the pessimistic, judgmental attitude or the optimistic, merciful attitude. When applied to the characters in King Lear, I choose to take the optimistic, merciful attitude. King Lear was betrayed by his two daughters Goneril and Regan. King Lear wanted to distribute his land according to the amount of love that this daughters had for him. Granted this was an illogical method, his intentions were not to destruct the family and himself. He was also very harsh to Cordelia, but the ultimate event that took place to leave him unaccommodated was the betrayal by Goneril and Regan. Lear put his trust in the wrong people, and it ended up placing him in a horrible situation. Now Lear did not make the smartest decisions, but what wrong did he commit in trusting his two daughters who professed their love for him to provide for his basic needs. "How sharper than a serpent's tooth it is to have a thankless child." ( I, iv,57). Lear voices his frustration with not being able to trust his own family members. Gloucester's downfall was also a case of betrayal. His illegitimate son, Edmond, betrayed him into thinking that Edgar, his legitimate son, was plotting against him. One might say that Gloucester was ignorant in believing Edmond, and that he was illogical in not confronting Edgar.

Market Research Proposal

Baby milk powder is growing strongly and rising as a necessary nutrition item for baby at the beginning of development state of life in Vietnam. According to â€Å"Baby formula price rise hits poor families† (2013), In recent years, many parents who very care about their children's development, usually choose milk which is imported from US or New Zealand because it may be more nutritious than domestic products although the price is higher than. Also, according to Euromonitor International (n. ), Vietnam is estimated as activeness and strongly develop economy, people are living ith the hectic lifestyles, shorter maternity leave and longer working hours lead woman spend less time for nursing their children. Therefore, they tend to nurse babies by infant formula which offers better nutrition and necessary vitamin for children. In this research, the research team aims to find the relevant information about infant formula market in Vietnam in order to help Oz Dairy Foods enter this market.By applying the qualitative research methods, especially in- depth interview, the research team wants to identify what Vietnamese parents expect and their perception toward foreign infant formula product. Through that, Oz Dairy Foods may have a suitable marketing strategy to achieve their goal. Secondary research a. Vietnam economy and population research According to World Bank, Vietnam is a lower middle income country which has Gross National Income (GNI) at 1,400 dollars in 2012. The GNI of Vietnam is still lower than average lower middle income level and the growth is Just parallel together.Comparing to other developing countries in East Asia ; Pacific, GNI of Vietnam is much lower and the gap will probably larger in the future. (Appendix: Figure 1) Moreover, according to the General Statistics Office of Vietnam, Vietnam's birth rate lightly grows to 16. 9 births/1000 people in 2012 which defines the increase in demand for infant formula. (Appendix: Figure 2) b. Market o verview Vietnam is highly competitive market for infant formula industry and dominated mainly by international companies including Abbott, Friesland Campina and Mead Johnson; and one domestic company, Vinamilk (Euromonitor, 2013).Dielac is the market leader of brand shares in 2012 and follows by Gain, Dutch Lady, PediaSure and Enfagrow (Appendix: Figure 3). Consequently, this will create many challenges in gaining and remaining market snares especially tor new entries. In general, powder ilks prices range from 1 50,000 to 800,000 VND/can that NET weight varies from 400gto 900g/ can. â€Å"Help growth and immune system† is the general message of current brands using to attract consumers. It tends to succeed in communicating outstanding quality of additional nutrition and vitamins to consumers.Besides many opportunities that Vietnam market brings to infant formula providers, they have to face with barriers from the government and consumers' expectation. According to Communist P arty of Vietnam online newspaper, Vietnam government applies tariff for imported brands at 10% that is highest in region. Moreover, the distribution system is fragmented and unorganized. The study of Euromonitor in March 2013 about infant formulas in Vietnam points out that Vietnamese parents are increasingly worried about nutrition in infant formula due to the negative effects of a series of scandals through media channels.The study also clarifies the challenge from Vietnamese government when there is a policy for restricted advertising on infant formula for children younger than two years old in effort to encourage breastfeeding. c. Forecast Despite the difficulty in economic growth, sale volume of infant formula is foreseen to each 53,402 tons in 2017 (Appendix: Figure 4). Consequently, the statistics proves that Vietnam is the potential market for infant formula. Research problem a.Research objectives – Identify Vietnamese customers' perception and expectations toward for eign infant formula product – Identify key factors that affect infant product marketing mix b. Research questions – Which constitutes that influence customers' decision in buying infant formula products? – What is customer's expectation towards price over value of infant formula product? – What is the most appropriate distribution and SCM for infant formula roduct to reach the majority of customers? – What kinds of promotion strategies and tools that could be successful in Vietnam infant formula product market? c.Research purpose: The purpose of this research is to determine Vietnamese customers' expectations toward foreign infant formula products; in order to construct appropriate marketing strategy that reaches the majority of customers. Without market research, the company might apply inappropriate marketing strategy; which might lead to failing in Vietnam infant formula market. Methodology a. Research method: Basically, to exploring the custome rs' perception and expectations toward infant ormula product, in-depth interviewing method will be applied as the most appropriate method for the company to chosen.Clearly, this is a type of qualitative research which could probably help the company to have a deep understanding about the infant formula market which focus group interview and quantitative methods cannot do. Moreover, two crucially important factors for doing in-depth interview are having more explanation and receiving better results when the respondent is not influenced by other respondents' opinions as well as there is more time and a comfort environment for the interview and respondent to discuss about he subjects. . Instrument development and fieldwork: In order to make the in-depth interview more completed, an interview guide which including prepared questions matching with the identified research problem and the research's needs will be created. Moreover, we will find around 10 appropriate respondents to do inter view with them in their preferred places. Furthermore, the chosen interviewer (from the group) needs to be trained and well-prepared before coming to the rendezvous to do the interview.For instance, the interviewer need to have a deep understanding about the research, the topics or questions need to be overed in the interview and also the respondents' background information to ensure that they can be able to control and lead the interview well. Additionally, when doing the in-depth interview, one member will take the role of an interviewer and the others member will take notes and record the interview. Namely, each in-depth interview between 1. 5 hours to 2 hours will be recorded on tape for the following analysis and completing the final report.At the end of the day, the whole group will collect all answers and analyze the data by using the data analysis methods mentioned below. c. Sampling: Target population: Demographic: infant formula product buyers (mother/father), married coup les tend to have baby – Geographic: Ho Chi Minh City – Gender: Male and Female – Age: Above 20 years old Sampling methods: Basically, there are two sampling methods including non-probability sampling and probability sampling. Probability sampling requires to have information from lists of available respondents; whereas, non-probability does not require them (Zikmund, 2010, pp. 37-338). Although results provided from probability sampling seem more accurate and credible, non-probability sampling is less expensive and save more ime to conduct. Thus, in the research of infant formula product, non-probability sampling method will be used. Specifically, convenience sampling which obtaining available information and respondents conveniently will be applied here. Sampling unit and size: Due to the limitations of time and resources, it is hard to do research on the whole HCMC's population so we Just can do interviews with around 10 respondents.Research Method Expected Sa mple Size Research Procedures In-depth Interview 10 HCMC'S citizens Step 1: – Prepare an interview guide – Prepare around 4 topics or 10 questions Step 2: – Contact with the chosen respondents for permission Step 3 1. 5 to 2 hours – Discussion and interaction – Record and take note Step 4: – Choose around 5 most relevant respondents to analyze : – Time frame: Data analysis method Firstly, field editing will be applied on the same day as the interview occurred to ensure that our group will gained appropriate information.To illustrate, the interviews will be double check by the whole team at the end of the day to avoid as much as possible problems. Clearly, the interviewer will go over his notes to find out inconsistence answers that are not correlated with the interviewee's answers. Secondly, coding open-ended questions will be used to categorize the interviewee's answers into different particular groups by sorting the key words from t heir provided answers.

Evolution of Human Resource to Human Capital: A Strategic Shift

As per the Darwin’s theory of evolution, everything has to evolve in order to sustain its identity. Corporate and its environment are changing every day as per the needs and behaviour of the customer. New strategies and concepts are evolving and the old concepts are either getting modified or are getting redundant if not practised. Knowledge of attracting, selecting, deploying and developing talent and strategies has given a competitive advantage to the companies.In line of this Human Resource, that was considered as a supporting coordinate in strategy formulation, now has taken a front lead in capital generation and hence regarded as the Human Capital. Peter Drucker famously defined a knowledge economy as one in which the human brain provides the primary means of production. He then noted the obvious corollary: that an organization’s most valuable resource is lodged in the heads of its employees and goes home with them at night. [Reference4].This is how firms have star ted involving employee participation at all levels for decision making and management forecasts (be it in any field, i. . Operations, finance, Marketing, Human Resource department etc. ) and not only a pre-selected group of individuals. Concepts like brainstorming of ideas have also evolved with the concept of human capital. In this article, let us first define human resource and human capital briefly. Human Resource was regarded as the set of individuals that forms the employee strength of any organization and its planning was typically considered as the process of anticipating and providing for the movement of people into, within and out of the organization.Previously firms were giving much importance to system implementation than human resource development as technology was much simpler. But with the advancement of technology and shortage of skilled manpower, firm has started giving respect to their employees and have initiated different measures to enhance their skills. This has generated the concept of Human Capital. Human capital narrowed the concept of human resource in terms of expertise and knowledge beneficial for the company. Human Capital describes the economic value of employees’ knowledge, skills and capabilities.This concept has highlighted the fact that success increasingly depends on an organization aptitude to manage talent and stressed upon the idea of â€Å"Compete through people†. In line of strategic planning that involves a set of procedures for making decision about the firm’s long term goals and strategies, human capital has taken the front seat. In the older model with the advancement of system technology, corporates started considering system before human resource. Their main goal was to make human resource as predictable as physical assets.But in last 40 years this concept has gradually changed and now the concepts like Toyota Production system pioneered the model that human resource come much before systems and that any individual on the production line had the capability often regarded as the ownership to point out problems and stop the line when proper standard operating procedures (SOP) is not being followed or some error has occurred. This has also extrapolated the idea that it is the human resource that drives and maintains the system and is not the other way round.It has also advanced the human resource processes to be continuous and not episodic as considered previously. Human capital is clearly different from the tangible monetary capital due to the distinguishing characteristic of human capital to grow cumulatively over a long span of time. Due to the shocks experienced in the business cycles it is difficult to maintain the linearity in growth of tangible monetary capital. During the period of prosperity, monetary capital grows at relatively higher magnitude while during the period of recession and depression; there is a dip in generation of monetary capital. Reference3].Contrary to this, human capital has uniformly rising rate of growth over a long period of time because the foundation of this human capital is laid down by the skills both technical as well as educational and health inputs. [Reference3]. The current generation is qualitatively developed by the effective inputs of education and health that will also benefit the future generation by its advance research and development. Thus the future generation gets refined day by day in terms of skills, production capacity etc. generating more human capital with superior quality.Firms have started banking upon their skill inventories for their business differentiation. Skill inventories list each employee’s education, past work experience, vocational interest, specific abilities and skills, compensation history and job tenure. IT hubs in Hyderabad, Bangalore etc. have banked upon their skill inventories and this has signified the rapid growth of Indian economy. Companies such as Mackenzie etc. has o ver a period of time emphasised and given inputs to develop a pool of human capital to gain the competitive advantage.Now the trategy formulation has moved from simple analysis to devising a coherent course of inputs and actions. Thus cumulative growth of Human Capital in India is evident. Countries like china have always banked upon their human capital for their economic growth. Many reasons explicitly explain the strategic change of human resource to human capital major of which is globalization. Globalization has led to multitasking of the employees where the work force is developed in a holistic manner to accomplish many tasks at one time. The resources are utilised in a much better way.Individual knowledge bases are continually changing and adapting to the real world in front of them. So the dimension of knowledge is not limited to demographic borders and has developed leaps and bounds. Training programs complement building the human capital by developing superior knowledge, sk ills and experience within the workforce. Managers of today are thriving to develop business agility in their team. Many development assignments are getting structured for employees, empowering them and ensuring that their job duties and requirements are flexible enough to allow growth and learning.Human capital is intangible and elusive and cannot be tapped the way organizations manage jobs, products and technologies. One of the reasons for this is that the employees, not the organization or system own their human capital. If valued employees leave a company, they take their human capital with them, and any investment the firm has made in training and developing those employees is lost. Technology advancement has also pioneered the shifting of human resource to human capital.Companies like Apple, Samsung are coming up with more than one product in a year where the human talent is used profusely to gain the technical niche. Advancement of technology tends to reduce the job openings that required little skill and increased the position that required considerable skills. This transformation has shifted the human resource from â€Å"touch labours† to â€Å"knowledge workers†, in which the employee responsibilities expand to map a richer array of activities such as planning, decision making and problem solving.Even the firm are preparing blue prints of programs to improve the skills of not only the upper management but also the middle and the lower management also. Firms are creating programs and awards like mentorship program, performance pay, incentives, bonuses and other awards for all level of employees to retain their human capital. Because employee skills, knowledge and abilities are amongst the most distinctive and renewable resources on which a company can draw, their strategic management is more important than ever. Reference2].Thus HR professional can concentrate more effectively on the firm premeditated direction instead of daily routine t asks. This blueprint can include forecasting personnel needs especially for firms planning to expand, contract or merge, planning for career and employee promotions, and evaluating the impact of the firm’s policies- both those related to HR functions and other functions- to improve the firm’s earning and strategic directions. But the main challenge comes in utilization of human resource as human capital.Without proper ownership and proper activities that capitalizes the workmanship of an employee, the part of the capital gets unutilized and goes as idle waste. Managers are architecting work for the employees in such a manner where they feel themselves connected and their skills are enhanced. This also catapults their full capacity utilization. The evolvement of this concept has inevitably changed the focus of firm from traditional Human Resource Management to strategic Human Capital Management.To be in the competition firms are using their human capital to implement bo th proactive and reactive change initiatives and are crossing the line to retain their human capital. Such is the magnitude of human capital in today’s scenario, where in a manager success is determined by the amount of human capital he has generated or retained in a year. The future depends on pursuing businesses that leverage human capital.

Electronic Health Record Essay

In the proposed scenario, a Clinical Nurse Specialist (CNS) with a Post-Masters Nursing Informatics Certificate has decided that the 100 bed hospital that she works in would benefit from transitioning from paper charting to using an electronic health record (EHR) system. She has done initial clinical research and has a solid foundation of best-patient-practice reasons that support this change. She has also researched and studied the information on the government’s websites HealthIT.gov, and CMS.gov pertaining to the American Recovery and Reinvestment Act and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. HITECH is a stimulus package approved by the US government allowing $19 billion dollars to be divided between hospitals and doctors â€Å" who demonstrate â€Å"meaningful use† of electronic medical records†(ARRA HITECH Solutions, 2015). She knows that the best way to select and institute an EHR is to assemble a team of m embers with various specialties pertaining to the goals outlined in the stages of HITECH. Stage 1- Data capture and sharing, Stage 2- Advance clinical processes and Stage 3- Improved outcomes. Each of these stages has it’s own meaningful use criteria. As seen in the diagram to the  left. The CNS begins by choosing the members of her team from various disciplines in the hospital. Because this will mean corporate wide changes and adoption. Her list includes the following, from the IT department, a Clinical Nursing Informatacist- chosen for a specialty in how nurses interact with software and what is required for nurses to effectively care for patients, and the Director of Clinical Informatics- chosen for an overall knowledge base of the hospitals informatics resources and requirements including what software and hardware is currently available, what has worked or failed in the past and what changes will need to happen to keep the hospital compliant with patient privacy and safety regulations. She will also need a Corporate Project Manager to organize and disseminate information to the various off-site entities related to the facilities that will need to be on board with this change across the corporation. A Chief Medical Information Officer will be key in providing the perspective of the physicians and their particular needs and goals, and to be a liaison for the staff physicians when the EHR rollout occurs. A Chief Information Officer will bring knowledge about the hospital’s day to day functions that will need to integrate into the new EHR along with how those systems currently function. A Chief Nursing Information Officer will have their finger on the pulse of each nursing unit and be aware of the different user interface requirements that will be needed by different departments for the the specific type of flow and care given. Lastly, a Chief Financial Officer will be able to guide the team on topics concerning governmental funding and current assets along with helping to create and maintain a budget as required with the acquisition of new software and hardware, he will also be able to work with each department’s budget makers when the time comes for allocating training hours and equipment purchases. Along the way the team will need to bring in sub-specialists to give information and feedback as they hone the new system, but for now the assembled team will be responsible for researching, choosing and implementing the best EHR for their hospital. A.2 a-e) Choose 2 real-life computerized management systems and analyze them by comparing their advantages and disadvantages, recommend the best choice to meet the ‘MU’ requirements, describe how the features of the recommended system meet the guidelines outlined in the three stages of meaningful use, describe the impact on quality of patient care, documentation and outcomes. The team is aware that currently they have a computerized system that they use for reporting and tracking labs, radiology and scheduling, but all documentation is paper based. They consider the price point involved with adding modules to the existing McKesson software vs purchasing and implementing an entirely new EHR called EPIC. EPIC appears to be user friendly and able to seamlessly connect all of the facilities under the umbrella of their corporation. They make a list of some of the pros and cons associated with each system. McKesson has the upside of being a system they have already worked with and it has different programs that can be pieced together to meet some of the meaningful use (MU) criteria for compliance. They already have a working relationship with this vendor and some experience with the product. Once the discussion gets going, the team realizes that there are many more bad points than good with McKesson. In their experience, the software modules are connected in a piecemeal fashion that makes it difficult for programs to interface. Quite frequently data is just lost and not retrievable. There are different data entry systems for the different types of departments i.e. OR, ER, labor &  delivery, Med/Surge, radiology, and pharmacy. The different systems do not allow for across the board data harvesting and that makes it difficult and time consuming to track reportable nursing and CMS indicators. The aesthetics of McKesson are something that is frequently complained about by the staff, due to lack of distinctive color transition and eye fatigue. Lastly, the group is very reluctant to continue on building their EHR base with McKesson because the PCPs in the area will not be able to access hospital records, and office visit information will not be available to the hospital based staff. Due to the need for increased man hours in servicing McKesson, lack of discrete data sampling, and the poor continuity of care related to PCPs not having access to hospital data and vice versa, the team decides to choose Epic instead. Epic has the down side of being a system that will require a large initial outlay of funds. The hospital will have to purchase software, and related hardware. They will have to expand the IT and biomedical engineering departments to support and maintain the new system and equipment (something that would have been necessary to a smaller degree with McKesson). They will have to address some retrofitting needs related to wiring and computer instillation and lastly training will be a very big issue. Despite the potential down sides, the team comes up with a long list of reasons that EPIC is the right system to choose. To begin with EPIC is all one system. It allows for seamless interdepartmental interfacing. The PCPs in the area already use a version of EPIC and this will allow for easy data exchange and a patient’s information will follow them easily. The EPIC system has a medication reconciliation form that is easily viewable to all care givers and pharmacies in the area, keeping track of each patients reported medication dose and frequency. EPIC has a ‘my chart’ feature that allows patients see labs, after visit summaries , and to interact with physicians about scheduling, medications and lab results. EPIC has  many built in safe guards, including password protection, continuous backup and recovery programs so no dat a is lost, and the vendor provides continuing support as needed. EPIC comes in 3 pre-bundled, customizable templates, each already set up to meet the Meaningful Use (MU) criteria without having to alter the program. The team can look at the three available options and determine if one fits them perfectly, or find the closest one and alter it to fit their specific needs. Some examples of how EPIC will meet the Stage 1 MU criteria are computerized physician order entry, checking for drug interactions and allergies automatically, tracking demographics, keeping current diagnosis, medication and allergy lists, allowing patients to have electronic access to discharge summaries, and it gives patients electronic access to physicians. Once the hospital has used EPIC for at least two years, some examples of how EPIC will help meet the Stage 2 MU criteria are ongoing patient data entry and discreet sampling for report generation. The team will continue to develop the software that demonstrates interoperability in sharing of lab results with other providers and systems. Security risk assessment will be ongoing and built into the system. Smoking status will be tracked on all patients 13 and older and the EPIC software is designed to guide the facility from meeting the Stage 1 criteria to meeting the Stage 2 criteria. Stage 3 MU objectives are projected to improve outcomes. The team is waiting on the final ruling for what the Stage 3 guidelines will be and in the mean time they have a projected goal of focusing on primary prevention measures and improving overall population health. This will include recommended vaccination reminders, smoking cessation assistance, healthy lifestyle and meal planning recommendations, and yearly checkup reminders generated by primary physicians that will crossover to hospital patient charts. Some of the better benefits of EPIC include point and click tabs in the assessment fields, this allows for discrete sampling of information. EPIC utilizes a reporting workbench that will harvest requested, reportable data  and assemble it into a user friendly template. This will benefit the hospita l by reducing former man-hours required to find and collect data for clinical quality measures, public health reporting, and CMS indicators. Discrete data sampling from EPIC will make the hospital a benefit to the community as well by allowing it to track trends and provide information to community health nurses. EPIC comes with the ability to establish hard stops and reminders that allow real-time users to be aware of needs for care coordination and patient specific follow-ups or recommended testing related to treating chronic conditions. It will also allow for symptom driven order entry fields to be immediately available in emergent situations where time taken to look for those things could mean a worse outcome. This is especially important when people present with symptoms of stroke or heart attack. Another EPIC benefit is the different levels of bedside specific PHI protection related to sensitive care. EPIC has a ‘break the glass’ functionality pertaining to all sexual assault and psychiatric admits. This function only allows relevant staff to open and view these patients charts, any others are shown a pop-up warning and a notice is sent to start an investigation of any other person who logs in to theses charts. The team is impressed with the information provided by EPIC concerning scanning patients and medications at the bedside and the reduction in medication errors this causes. The scanners will integrate with the medication dispensing machines already in use at the hospital. One of the major benefits of EPIC is the order entry build. Each physician, with a minimal amount of training, can customize the order entry process to reflect their needs. Medication orders are instantly linked to a pharmacist to double check for allergies, and correct dosing information, and then the medication becomes available, via PYXIS machines on the unit for the RN to administer at the bedside. The bedside dosing requires the patient and medication to be scanned, further eliminating potential erro rs, and provides a pop-up warning if an emergency override is required during any of these steps. While the team acknowledges that training and time to become familiar with the new charting and bedside routine changes will initially impact patient care in a negative way, they have a plan in mind to keep the patients educated on the new system changes and the anticipated better care available to the patients across the board from instituting an EHR system. Having the patients ask questions and give real time feedback will help the team tweek their training and bedside routines to give better, more organized care that results in trackable outcomes. This is just an overview of some of the many functions EPIC has that persuaded the team to choose it as the new EHR system for the hospital. (EPIC and McKesson related information was culled from the authors own experience with the systems and personal interviews with multiple members of the informatics department at St Francis Hospital, Indianapolis campus). A.3 a) Use of Quality Improvement Data EPIC has point and click assessment tabs and a standardized documentation format that links related data. This allows for discrete data sampling related to things like CMS indicators. The hospital will be able to track compliance with things like ‘door to EKG’ times in the emergency department, Foley catheter use and resultant CAUTIs, and the time from when a patient presents with stroke symptoms until a cat scan is done and/or whether the patient receives antithrombolytics as a result. The hospital will also be able to generate reports on errors that occur the via the Risk Monitor Pro incident tracking software. This will allow them to continue researching and improving processes. A. 3 b) Security Standards and Methods EPIC has 24 hour monitoring of staff use while logged in, and the records they access. This is important because hundreds of staff members will be using the system and there has to be accountability if employees were to look up their own records, or the records of friends or family. This  information can be tracked and the employee interviewed and disciplined if needed. EPIC also comes equipped with incident reporting software called Risk Monitor Pro. All staff members are encouraged to use this format to report any incident that might warrant further investigation. It covers every location, type of employee, type of equipment, patient, visitor or vendor. Risk Monitor Pro forms are used to report potential or perceived injuries, faulty equipment, sentinel events and things that have the potential to cause harm or damage. This information can be followed up on by the risk management team, so that process improvement is an ongoing process. The team works with members from the IT department and plans for primary data storage with a redundant back up storage unit that simultaneously updates so if the primary server fails there is no loss of information. They have also planned for a second, off site data storage center that can be used in case of emergency to ensure continuity of services, and keep things up and running while the primary system is off line for upgrades. Lastly back up tapes will be kept at a third site in case both of these areas are compromised, and the system can be rebooted and running again within 72 hours. A. 3 c) Explain how the system will protect patient privacy and meet HIPAA requirements EPIC will protect patient privacy in a number of ways. End User access is limited to only being able to access the information needed to do their jobs. Making the accessible information different for nurses, physicians, registration clerks, radiology technicians, committee members etc. Personnel will only be granted access once they have completed security training and have signed documentation stating that they understand the legal risks and responsibilities when accessing protected health information (PHI). Individuals outside the hospital will have access to EPIC as well, for example nursing home physicians. They will have a read only access granted, but will require multiple patient identifiers to access the information. Also, as mentioned earlier, EPIC will employ security related  chart hard stops like ‘Break the Glass’. A. 3 d) Explain how the recommended system meets HIPAA requirements EPIC helps to meet HIPAA requirements with automated enforcing of access policies, and pro-active alerting that links directly to the risk management department, requiring strong password policies, and automatic logout at end user work stations. EPIC allows providers to protect the integrity of data and recover original data in the case of it being altered or damaged. EPIC users are required to have appropriate training to be able to access the system, and can be locked out in the case of termination. Portable devices carry encryption software that does not allow for third party data extraction or access. EPIC can also quickly generate reports with discrete sampling related to various forms of access. The majority of compliance will be the responsibility of the staff with written policies, documented sanction programs and investigation that is on-going, consistent and documented. A. 3 e) Describe how adopting the system will reduce costs to the organization Instituting this new system will initially generate more costs, but in the long run will save the hospital money in many ways. Meeting the ARRA/HITECH Act requirements will help to offset those cost with financial incentives and avoiding fines and penalties. Having readily available test results will decrease the costs and labor associated with repeating lost or illegible results. With superior organization and data summary tools, the cost for labor associated with studying charts individually and generating reports will be exponentially lower. The need for transcriptionists will be greatly reduced by utilizing dictation software. Facilities for storage of paper charting cost money for upkeep and staffing. An electronic database should make billing and insurance claims easier to process and thereby generate revenue faster. The time it takes for physicians to spend going over complicated medical histories with patients is greatly reduced by  having that information readily available in a database. â€Å"According to a recent study, when hospitals rely on advanced electronic health records they can save up to 10 percent per patient admission† (â€Å"Advanced EHR Cuts Hospital Costs By 10% Per Admission,† 2014). 4. A) Explain why active nursing involvement in the planning, selection, and implementation of the systems is important to the success of the implementation process and meeting meaningful use requirements Active nursing involvement is important to the success of implementing any process that affects care given at the bedside. For the system to be optimized for use, nursing suggestions and feedback are critical. EPIC knows this and has a team of nurses on staff to work with the facility  in developing end-user interface. ‘Nurses’ from the hospital include the advocates, CNS’s, NP’s, LPN’s, managers, and bedside care givers, each with a specific focus and experiences that are valuable when helping to decide how charting should work. Any thing that pulls a nurses attention away from the patient, or is distracting or difficult to work with decreases the perceived level of care and increases the potential for errors. The health care goals of meaningful use include improving efficiency, safety and quality while decreasing discrepancies, involving patients and their families in their care, improving public health outcomes, improving care coordination, and advancing security and privacy of PHI (Gregory & Klepfer, 2010). All of these things are the foundation of every interaction a nurse has with a patient. This is why nursing is one of the most trusted professions, according to the Gallup pole website, nurses come out on top at 80% when people were asked to rate â€Å"the honesty and ethical standards of people† in different given fields (â€Å"Honesty/Ethics in Professions | Gallup Historical Trends,† n.d.). Because standard nursing care already meets the goals outlined for meaningful use, the most important thing the average  nurse can do is to work hard to be competent utilizing the selected EHR software. Advanced users and nurse leaders are important to help guide the EHR selection process in the direction that will improve the bedside interactions and user interface. Clinical nurse specialists have advanced educations and bring the nursing philosophy to the selection and implementation process. All of these roles are vital to the success of any EHR implementation.

Evaluation of Maladaptive Behavior Essay

Maladaptive behavior is commonly observed in children who have troubled family lives or low self esteem (Maladaptive Behavior, 2003). In this case, there could be several reasons that the child is exhibiting and engaging in maladaptive behavior related to his environment at home. Using a variety of theories of moral development as well as a question-answer evaluation of the parenting styles of the child’s parents, the maladaptive behavior seen in the child as well as a solution will try to be understood. Different types of maladaptive behavior are attributed to different problems. While most parents simply believe that their child is misbehaving, maladaptive behavior is usually classified in groupings such as attention-seeking or revengeful, behavior inappropriateness (Maladaptive Behavior, 2003). The child being observed exhibits both types of maladaptive behavior, which can most likely be explained by moral development theories and poor parenting. For the behaviors such as repeating swear words, throwing food on the floor, drawing on the walls, and screaming in public, it is most likely a result of a self esteem or attention-seeking issue. The child is trying to get in trouble to get attention from the parents (Maladaptive Behavior, 2003). The child knows these behaviors are bad as Kohlberg states, â€Å"younger school-aged children tend to think either in terms of concrete, unvarying rules†¦or in terms of the rules of society†(Feldman, 2011; p. 311). However, the child also knows that participating in these behaviors will result in attention from the parents. The child is obviously aware that these actions are not societally accepted because it is likely that they have not observed them in their teachers, parents or other powerful authority figures (Feldman, 2011). In this area of maladaptive behavior, it would seem that the parents might have an uninvolved parenting style. To determine if this is true, the parents should be asked questions about their involvement with the child and how concerned they are with aspects of his development other than their role as a provider. The following questions would suffice: Do you believe that your only job is to feed, clothe, and shelter your child? (Feldman, 2011) Is there any child abuse or neglect in the family? (Feldman, 2011) How involved with your child would you say you are on a day-to-day basic, specifically related to disciplining their behavior? (Feldman, 2011) These would all be important to ask because if their answers indicate that they are neglectful, uninvolved in disciplinary as well as other areas of development, or confused on their role as a parent, they may be uninvolved parents. According to the textbook, â€Å"Children whose parents show uninvolved parenting styles are the worst off†¦their parents’ lack of involvement disrupts their emotional development, leading them to feel unloved†(Feldman, 2011; p. 317). This could make them act out in an attempt to get the attention of their indifferent or detached parents. The reasons behind the child’s behavior of hitting other children in daycare and ignoring direct commands from parents may be more along the lines of revengeful maladaptive behavior as it is intentional causation of harm to another student or person (Maladaptive Behavior, 2003). According to Piaget, children in the heteronomous stage, which happens in the early years of childhood, believe in immanent justice, â€Å"the notion that rules that are broken earn immediate punishment†(Feldman, 2011; p. 309). For this child, it is possible that he does not understand that his behavior is unacceptable even if he is mad at another student. This is probably the result of permissive parenting by the parents. The student most likely has never known that his behavior is bad because permissive parents such as his â€Å"provide lax and inconsistent feedback†¦and place little or no limits or control on their childrens behavior† (Feldman, 2011; p.316). To determine if this is true of the parents’ style of discipline the following questions could be asked: Do you expect a lot from your child in the areas of behavior? Would you ever be punitive or clear and consistent in your limits with your child? It they answer that they have few expectations, would rarely limit their children, or are inconsistent with their discipline it is possible that their permissiveness is causing the child to act badly in school and disregard their correction when it is given. Based on the observation of the parenting styles the child sees at home as well as the information from the moral development theories, it is clear that the parents are most likely at fault for their child’s maladaptive behavior. If they want their child to correct his behavior, they should engage in more authoritative parenting as children raised in this parenting style â€Å"fare best†¦are independent, friendly with peers, and cooperative† (Feldman, 2011; p.317). The parent should, as a part of this parenting style, be firm and set clear and consistent limits on their children. Additionally, induction, or discipline paired with explanation, can also be used so the child knows what they did and why it was wrong and can correct it in the future (Lee, 2013). References Feldman, R.S. (2011). Life span development: A topical approach. Upper Saddle River, NJ: Prentice Hall. Lee, M. (2013, April 1). Class #28: Prosocial Behavior, Values, and Spirituality. GPSYCH 160: Life Span Human Development – Section 8. Lecture conducted from James Madison University, Harrisonburg, VA. Maladaptive Behavior. (2003). Retrieved April 8, 2013, from http://disease.disease.com/Therapy/Behavior/maladaptive-behavior.html

HUMAN RESOURCE Term Paper Example | Topics and Well Written Essays - 1000 words

HUMAN RESOURCE - Term Paper Example There are five factors to be analysed in the porters five forces and they are analysed below in correlation with the Apple Computers. The threat of the entry of new competitors The personal computers industry is the major threat for Apple Computers including the old competitors for Apple Computers. Competitors are coming up with innovative products that may cause the Apple Computers to face tough king of competition in the future. The intensity of competitive rivalry The intensity of competitive rivalry tends to focus on the elements such as the price of the product, the innovation and quality level of the product. All these factors are compared with the competition in the market. Companies that use advance technology tend to be stable in a competitive environment such as Apple Computers. Competitive rivalry faced by Apple Computers is from Dell incorporation, Hewlett Packard Company, and Microsoft Corporation. Dell computers have one of the most unique strategies in providing custom ized notebook and laptops to its customers, according to their needs and wants. Apple faces intense competition from Microsoft in areas of portable music players and other type soft software. The threat of substitute products or services Apple faces one of the biggest threats from its substitute products & services. The era of converging to the digital types of devices such as MP3’s, cell phones, playing games, and picture taking along with the internet has challenged Apple to a very large extent. iPod franchising protection is the biggest challenge for Apple computers. The bargaining power of customers Customers have a lot of choices from which they can choose their computer devices. The switching costs of customers are high and they have a lot of information available of other competitor products, but Apple computers have made their mark in all fields and they may not be facing high competition from the bargaining power of customers. The bargaining power of suppliers Apple computers although does not provide low quality products but still companies like IBM and Motorola may work intensively on every inch of computer production and therefore cause a threat from the bargaining power of suppliers. High switching costs are faced when Apple opts for changing suppliers. Generic business strategies The generic strategies from the Porter’s framework being practiced by Apple Computers are mostly the differentiation element and the focus element of the strategy framework. Apple computers imposes the differentiation strategy through their use friendly graphic interface and the integration of products and services is the main focus and target of Apple computers that makes them successful and is few of the sources that allow them to gain a competitive advantage. For having a stable focus, Apple computers segment their target market according to consumer characteristics so that consumers of their products are satisfied. HR policies of Apple Computers