Patient Safety in a Hospital Research

Patient Safety in a Hospital Research Attitudes toward incident reporting. Attitudes and perceived barriers to incident reporting among tertiary level health professionals were researched by Malik, Alam, Mir, Abbas (2010) to address the limited incident reporting framework in Pakistan. A random sample of 217 doctors and nurses in Shifa International Hospitals were given a modified version of the AHRQ’s questionnaire to determine various factors that influence health professionals’ reporting behaviors, with an important focus of the study on barriers to incident reporting. Results of the study found that only 20% of house officers are willing to report, and greater than 95% of consultants, registrars, medical officers, and nurses are willing to report incidents related to them. ‘Administration sanction’ was identified as a common barrier among doctors (69%) and nurses (67%). Additionally, reporting to the head of the department was preferred by doctors (60%) and nurses (80%). Based on the study ’s findings, the researchers suggest that implementation of future incident reporting systems should consider supportive work environments, prompt feedback, and immunity from administration (Malik, Alam, Mir, Abbas, 2010). Intensive Care Unit Registered Nurses’ perceptions of patient safety climate and potential predictors for patient safety perception and incident reporting were explored in a cross-sectional study by Ballangrud, Hedelin, Hall-Lord (2012). In ten ICUs in six hospitals in Norway, 220 nurses (72%) responded to the questionnaire, The Hospital Survey on Patient Safety Culture. The questionnaire measured seven unit level and three hospital level patient safety climate dimensions, along with two outcome items. Of the 12 dimensions, 7 achieved a RN proportion of positive scores (over 55%), and 5 achieved a lower proportion. Among types of units and between hospitals, significant differences in RNs’ perceptions of patient safety were found. Unit level variables were found to have had significant impact on the outcome dimensions, â€Å"overall perception of safety† and â€Å"frequency of incident reporting,† in which both had a 32% total variance. However, among the outcome variables, differences were found in positive scores on â€Å"overall perception of safety† (69%) and â€Å"frequency of incident reporting† (18%). In all dimensions, the total average of positive scores was 55%. This study concluded that patient safety climate was most positive among ICU RNs at the unit level, and areas for improvement include: â€Å"incident reporting, feedback and communication about errors, and organizational learning and continuous improvement† (p. 352). This study identifies several limitations. In contrast to other Norwegian HSPOSC studies, which included various health care professionals, this study’s sample only included RNs. Additionally, generalizability is limited since the hospitals in this study were small and within a limited area of Norway. Another limitation to this study that may have impacted the results was the known implementation of reorganization across units that were to occur after data collection. Perceptions of patient safety culture. In China, healthcare workers’ attitudes and perceptions of patient safety culture were explored using a modified version of the Hospital Survey on Patient Safety Culture (HSPSC), which measured 10 patient safety culture dimensions. Out of the 1500 questionnaires that were distributed to primarily internal physicians and nurses among 32 hospitals in China, valid responses were received from 1160 health care workers. Statistical analysis was done using SPSS 17.0 and Microsoft Excel 2007, including descriptive statistics, along with analysis of the survey’s validity and reliability. Two separate investigators entered and verified data independently. For each item, results included a positive response rate range of 36% to 89%. On 5 dimensions (Teamwork Within Units, Organization Learning-Continuous Improvement, Communication Openness, Non-punitive Response and Teamwork Across Units), the positive response rate was higher when compared to AHRQ data (P In a research study among 42 Taiwan hospitals, the HSOPSC questionnaire was used by Chen Li (2010) to examine the 12 patient safety culture dimensions. A total of 788 physicians, nurses, and non-clinical staff completed the survey. Statistical analysis was done using SPSS 15.0 for Windows and Amos 7 software tools. Positive perceptions were found toward patient safety culture among Taiwan hospital staff, in which percentage of positive response rates were highest among â€Å"teamwork within units,† and lowest in the â€Å"staffing† dimension. Taiwan and the US differed in the following three dimensions: Feedback and communication about error, Communication openness, and Frequency of event reporting. Several strengths and weaknesses were identified in this study. When compared to the original AHRQ database, which included large samples in various health care organizations, this study’s data had a lower internal consistency. The use of the HSOPSC questionnaire is both a strength and limitation in this study. Although the HSOPSC’s strong psychometric properties and broad safety culture coverage are considered strengths, the use of this questionnaire in Taiwan is also a limitation of this study because of its use in a cultural setting different from where it was developed. However, it is important to note that the application of the HSOPSC in Taiwan was found to be a good fit according to most of the confirmatory factor analysis indices. Based on their findings, Chen Li (2010) point out that, â€Å"the existence of discrepancies between the US data and the Taiwanese data suggest that cultural uniqueness should be taken into consideration whenever safety culture measurement tools are applied in different cultural settings† (p. 1). Not only is future research recommended to expand the survey in Taiwan, but also to consider measurements that will decipher individual and group perceptions and interactions related to patient safety c ulture.

Bessie Coleman :: essays research papers

Elizabeth â€Å"Bessie† Coleman was born on January 26, 1892 to Susan and George Coleman who had a large family in Texas. At the time of Bessie’s birth, her parents had already been married for seventeen years and already had nine children, Bessie was the tenth, and she would later have twelve brothers and sisters. Even when she was small, Bessie had to deal with issues about race. Her father was of African American and Cherokee Indian decent, and her mother was black which made it difficult from the start for her to be accepted. Her parents were sharecroppers and her life was filled with renter farms and continuous labor. Then, when Bessie was two, her father decided to move himself and his family to Waxahacie, Texas. He thought that it would offer more opportunities for work, if he were to live in a cotton town. While Bessie was young, and her older brothers and sisters started to work in the fields, Bessie took on some new responsibilities. She would now look after her sisters, and sometimes even help her mother in the garden. Bessie started school when she was six years old and walked four miles to school everyday. In school, she was very intelligent and excelled at math. Then, in 1901, when Bessie was nine, her life changed dramatically, her father George Coleman left his family. It was said that he was tired of the racial barriers that existed, and so he returned to Oklahoma (Indian Territory as it was called then) to search for better opportunities. When he was unable to convince his family to come with him, he left Susan and his family. Shortly thereafter, her older brothers also moved out, leaving Susan with four girls under the age of nine. This caused Susan to have to get a job, which she found very soon. She became a housekeeper for Mr. and Mrs. Jones, who allowed Susan to still li ve at home, and they would also give her food and other handed-down clothing. Since her mother was now at work, Bessie took on the responsibility of acting as a mother and a housekeeper. Every year at the cotton harvest, Bessie’s routine was changed because she now had to go out into the field and pick cotton for her family to be able to survive. This continued on until Bessie was twelve, and this was when she was accepted into the Missionary Baptist Church, where she completed all of her eight grades.

Is the Notion of an Early Modern Military Revolution Tenable? Essays

Is the Notion of an Early Modern Military Revolution Tenable? The notion of an early modern military revolution is one which is a much debated subject among historians. Two historians who are very dominant in this field are Geoffrey Parker and Michael Roberts. Although they both agree that a military revolution occurred, they disagree on the timing of a revolution in war. Roberts argues that a military revolution started in 1560 and "by 1660, the modern art of war had come to birth." Parker, on the other hand, sees the military revolution as a "firmly sixteenth century phenomenon with antecedents in the fifteenth." Prior to the early modern period, warfare was based around castles and fortified towns and attempts to capture them. This changed very little in the middle ages. Armies had a maximum of forty thousand soldiers, many of whom were mercenaries (1550). Armies consisted of Pike men in square formations supported by cavalry and musketeers. Battles often ended in a stalemate and wars were very lengthy as a result of this. Through the military revolution emerged new tactics, technology and style of warfare. Michael Roberts acknowledged four revolutionary traits of what he called the military revolution. "First, the superiority of disciplined infantry - musketeers rather than pike men - armed and drilled to prosecute a field battle by the ordered application of firepower, not the hurly-burly of man-man combat; second, themanifestly greater size of these new-style, mostly musketeer armies; third, the emergence of bolder, more dramatic strategies designed to seek a decisive battle at the culmi nation of a sharp campaign; and fourth, a need for larger and more reliable and intrusive commissariats and military bureaucraci... ...tary revolution occurred is not tenable but the notion that the face of warfare, the order of the world and the way people perceived war changed in this period and has shaped the modern world definitely is tenable. Bibliography Jeremy Black Ed: European Warfare 1453 - 1815 (Problems in Focus) Macmillan Press Limited 1999 H. G. Koenigsberger: Early Modern Europe 1500 - 1789 (The Silver Library) Pearson Education Limited 1987 J. M. Roberts: The Penguin History of Europe Penguin Books 1997 Michael Roberts: The Military Revolution 1560 - 1660 Boulder, CO, 1995 G Parker: The Military Revolution: Military Innovation and the Rise of the West 1500 - 1800 Second Edition Cambridge University Press 1996 G Parker Ed: The Cambridge Illustrated History of Warfare Cambridge University Press 1995 Stephen J. Lee: The Thirty Years War TJ Press (Padstow) 1991

Blue Collar vs. White Collar Work Essay

Throughout history the lives of the people in the working class have not always been easy. People always work hard to earn money and support their families; however, people don’t always work in a suitable working area. The term â€Å"Blue Collar† is jobs that require manual labor from people. The problem with these kinds of jobs is that the places the people work in can be extremely unsanitary and may cause a bad working environment for the people in it. Blue collar work is also the work most people do not want to do but it is needed for the people who do white collar jobs to prosper. Also blue collar workers are known as people who did not do well in school or people that aren’t smart. Well that is not the case with these workers because without them we wouldn’t be able to do some of the things we do now or be able to survive. Also some blue collar workers are called undocumented workers in which they don’t have any documents to prove that they can work or are from this country but help the country in doing jobs that are needed for a low wage. Therefore blue collar workers are a very important part to society and we need them to thrive. For example in â€Å"Made in L.A† there are 3 young Latina immigrants who work in Los Angeles sweatshops they do manual labor for an extremely low wage. Even though they did the same work as others they got paid less because they are immigrants, it is hard work with low wages but they continue to do it to support themselves and their family just like the blue collar workers do nowadays. With the little voice they had, they protested and tried to make a difference for all future immigrant workers not to be treated inferior to them. People in blue collar jobs get paid less than white collar workers which are office work but they enjoy their job other than others even though it is dirty. Even though the U.S has strict policies on immigrants, they are actually needed because they do many of the blue collar jobs that are needed in the country. For example in the article â€Å"Putting a S top to Slave Labor† it says that† If we required good documents starting tomorrow, the nation would plunge into an instantaneous economic crisis† (p156). This would happen due the fact that they do most of the jobs that people don’t want to do and get low wages also which are blue collar jobs. There are many instances of unsanitary work places. In the article â€Å"Migrant Farm Worker,† by Studs Terkel shows the conditions of the working place and also shows child labor. He says the animals were being treated better than the workers themselves. â€Å"Veterinarians tend to the needs of domestic animals but they can’t have medical care for the workers.†(p133) this shows that the bosses who supply these people with blue collar jobs are being taken advantage of and that the animals are living better than the workers. Also this goes to show what little care the bosses had for their people and that they only cared about the money instead of the needs of these people. People need to see the working class as people rather than machines that do something over and over again. Just because someone has to work hours in front of a machine and have a dirty job does not mean that the person is not a human being. There are many people needed in the world to do some jobs that which most people would not do. If we didn’t have those kind of people and if everyone wanted to do the same thing as everyone else than we would have a hard time surviving since it is needed to be done. â€Å"The case for working with your Hands,† states â€Å"More fundamentally, now as ever, somebody has to actually do things: fix our cars, unclog our toilets, and build our houses.†(18) This goes to show that if no one does those jobs there would be a lot of problems and that we always are going to need blue collar workers perhaps more than white collar in most cases. â€Å"The Case for Working with Your Hands,† also states â€Å"The trades suffer from low prestige and I believe this is based on a simple mistake. Because work is dirty, many people assume it is also stupid.†(19) The thing that people don’t realize is that not every job is going to appeal to them because we are all different and different people do different things, just as some people like to sit behind a computer everyday some people will not do that. The treatment of workers is a growing issue and it’s going to keep on growing and growing if people don’t realize what these big companies are doing and put a stop to it. For example the shoe company Nike employs many people but the thing people don’t know is that there are 12,000 young women in Indonesia making the lowest amount of money and working long tiring shifts. Every $80 sneaker Nike makes it only costs them 12 cents for the labor. This shows the unfair treatment of these workers and how the company is taking advantage of them and it is not only Nike doing this but any major company uses the same force of labor. In â€Å"Who Makes the Clothes We Wear?† it says â€Å"Government officials raided a sweatshop filled with immigrant Thai women laboring as little as 59 cents per hour.†Also not only were they being taken advantage of the discipline was enforced by threats of rape and beatings.(26) This goes to show the little care they have for these workers and the actions that are being taken against them. It also shows a dark side to these companies in which the workers are being treated worst than dogs. In the article â€Å"Reapers† by Jean Toomer it says that â€Å"Black horses drive a mower through the weeds and there, a field rat, startled, squealing bleeds, His belly close to ground. I see the blade, Blood-stained, continue cutting weeds and shade.† (37) This article shows tough field work for black people back around the 60s. They were bleeding but their determination was too great and they continued to go and do their work. Slavery could be identified as blue collar work also. In the article â€Å"What to the Slave is the Fourth of July?† Frederick Douglass says â€Å"There is not a man beneath the canopy of heaven who does not know that slavery is wrong for him.† (140)This shows that everyone knows that slavery is wrong but they continue to do it disregard the health of the workers but the financial health of a company or a person. Slaves have to endure much pain and long haggard days with little to no pay working out on the fields and any other job that another man won’t do. Just like the slaves do these kinds of work the women in Indonesia could be compared to them because of the long working hours and the little pay with strict discipline. There is a growing problem with Third World women and how they are being used. The companies get young girls and give them work usually being blue collar work with bad working conditions and poor pay. In the article â€Å"Life on the Global Assembly Line,† it says â€Å"Older† women, aged 23 or 24, are likely to be laid off and not rehired. The lucky ones find husbands. The unlucky ones find themselves at the margins of society-as bar girls, â€Å"hostesses,† or prostitutes.†(29) This displays the women as disposable workers; once they get too old they are thrown out and out of a job. After that these women don’t have anywhere to go, some get a husband and are being taken care of and others have to resort to whatever that is needed to be done to get by. Although the problems to these blue collar workers are plain to see, the fact is that the country needs them for the economy to thrive. Even if blue collar workers are needed to have a successful economy it doesn’t change the fact that they need to be treated like people and not like dogs on the street.

Cause-Effect Essay* Causes of Divorce

You know that divorce is more common nowdays, but do you know the causes? According to the statistics offered by INEGI in a survey practiced in 2005, 70% of the couples who get married take the decision of getting divorce. There are many reasons why they make yhis decision, but there are three main causes which are lack of communication, financial issues, and abuse. Lack of communication is one of the main causes of divorce.A marriege is on the rocks when the lines of communication fail. You cannot have an ineffective realtionship if either one of you does not discuss about his/her feelings, cannot talk about his/her mutual or personal issues, and expects his/her partner to guess what the whole problem is about. Another cause of divorce are financial issues. Money or aspects related to ot are of course a possible cause of disagreement between couples.Married couples could squabble over such issues as shared financial responsibility, unequal financial status, undisclosed financial sta te, over spending, and lack of financial support. The last cause of divorce are the ways of abuse. This does not just include intentional and habitual phusycal abuse. It may also come in the form of sexual abuse and emmotional abuse. One partner may actively seeks to degrade his/her partner through harsh language.Drug and alcohol make the person so violent; in addition, there may be no physical or verbal abuse, but the other partner would understandibly have a difficult time managing finances and daily life with an addicted spouse. Now we know that lack of communication, financial problems, and violence are the main causes why people get divorce. May be you should considet living in free union for a short time before you get married, by doing this, you can meet your partner well. It is not the best option, but if you are really in love, you can get married without any problem.

Sunrise Over Fallujah

Last Year Popular author Walter Dean Meyers published his newly book titled Sunrise Over Fallujah, His final book in the anticipated war series. This is the best war book he has ever written. Since he was in Vietnam, and he has relatives that have fought in the war against terrorism. So he has major experience in the war factor, knowing what could possibly be going on. Sunrise Over Fallujah is about a teenage boy from Harlem, New York. His name is Robin, and he joined the army. He's not so sure why he did because he is always so nervous about it. When he joins he meets someone named Jonesy. Jonesy black man who is very confident in himself and loves to write and listen to blues music. Robin also meets some pretty harsh people like Marla, Marla is a very pretty lady who thinks she is better then everyone she meets. In the beginning of the book it starts off describing how Iraq is and if Robin is going to be in the war. Everyone wants to go into the war for some reason, but Robin, and Jonesy are pretty nervous about it. Since Mr. Meyers knows about war there’s nothing in this book that can disappoint. The real problem is that they have their enemies trying to get them with detonators, and other dangerous explosive weapons. Mr. Meyers shows in this book how soldiers can grow brotherhood with other soldiers. He is very descriptive so it’s like you’re watching a movie. Meyers shows how gruesome war could really be. He also shows that the war could effect everyone including children. In the end Jonesy becoming a hero, and Robin overcame his worries. Jonesy became a hero because a blind kid was lost in a street battle and Jonesy ran after him and saved him. Then later Jonesy died because of his gun wounds he had suffered. Robin finally became used to the fact that he was in the army, and stopped worrying.

Position paper †Accreditation Essay

Hello, This assignment is for a subject called: Quality Management for Health Services Assignment 2: Position paper – Accreditation Weighting: 20% Length: 1000 words â€Å"Accreditation programs for health services or facilities are not useful.† Discuss this statement with reference to specific accreditation programs. In your response substantiate your claims with reference to literature. The assignment will be marked using the following criteria: 1. Style, organization and presentation 10% [2 marks] 2. Demonstrated understanding of principles and frameworks of accreditation 30% [6 marks] 3. Description of strengths and/or weaknesses of accreditation programs 30% [6 marks] 4. Identification of opportunities for improvements in accreditation programs 30% [6 marks].   Introduction – Accreditation is a process of certifying and approving that the services or products produced by a certain organization meet with certain standards in quality.   In Australia, one of the organizations that provide accreditation for hospitals and other healthcare organizations is the Australian Council on Healthcare Standards (ACHS). The main objective of this organization is to improve the quality of healthcare in Australian hospitals. ACHS is an independent organization that works for non-profit purposes and conducts reviews of the performance, quality assessments, etc, during the accreditation process. It was formed in the year 1974, and several other organizations such as the Australian Medical Council, the Australian Healthcare Association, and the medical colleges association have approved accreditation by the ACHS. For determining the standards in the level of healthcare, a committee formed containing representatives from various sectors of the population including the general public, government, hospitals, etc. The Council members vote for the Board of Directors. In the year 1996, the ACHS had launched a unique quality program titled Evaluation and Quality Improvement Program (EQuIP), the main aim of which was to deliver customer-oriented healthcare services to the people. A systematic external peer review process was set in place to closely monitor the program. The ACHS has about an 800-organization subscription and also acts as a consultancy to several other organizations throughout the world (ACHS, 2007). Body – Accreditation is a means of issuing trust. Any consumer who requires healthcare services desires those healthcare services to be of good quality and ensuring safety. It can be understood that in healthcare there are certain amount of risks, which can only be reduced to a certain extent. Accreditation is one of the means by which these risks can be reduced and quality care can be ensured. The patients should identify means by which these risks can be reduced.   Through accreditation, the entire process of providing medical care is well documented, besides being fool proof.   This would ensure that a process would be setup that would be based on strong evidences, ensuring better patient management.   Accreditation is often determined by the healthcare and the accreditation organization in strong technical terms that have to be fulfilled (ACHS, 2007). In the year 2006, the Australian Commission that maintained safety and quality in the healthcare sector felt accreditation standards needed to be improved.   They also felt that an independent review process was needed to raise the level of adherence to quality standards in healthcare organizations in Australia.   The organization felt that accreditation is a process to publicly recognize the achievements and adherence of the healthcare organizations national standards. Accreditation should be made available to all public and private sector organizations, and at different levels including community-based, private-health setups and tertiary healthcare organizations.   The accreditation organization should function independent of the organizations that it would be accrediting.   This would ensure that the performance and the standards that are present in the organization are given no bias by the accrediting organization (ACHS, 2007). Benefits of the accreditation system: – Greater involvement of the public and the healthcare organizations The clinicians who are responsible for providing quality care can be involved. Improves the community confidence levels in the healthcare system Better risk management in patient care Better compliance with the laws (reduction in medical malpractice cases) Patient safety standards are improved Education of the staff members towards developing good practices Provision of professional advice and guidance Staff education and training Developing strong mission statements, values and objectives for the organization The human resource processes can be effectively handled Compliance with the standards imposed by the regulatory bodies Better management of insurance claims and those of third parties Reduction in the insurance costs Better handling of the organization and the management Better flow of information Better decision-making processes Co-ordination can be improved Building a proper evaluation system Developing areas in which priority and attention is required (Australian Commission on Safety and Quality in Health Care, 2007 & JCAHO, 2007) Disadvantages would also be applicable, including: – Huge costs of accreditation which is finally passed on to the patient Emphasis on resources such as human, support systems, etc. The standards have to be continually updated, changing the area of concentration Accreditation would concentrate on improving structure rather than services Greater attention on increasing collaboration and partnership It may be difficult to streamline the processes Accreditation may not have an effect over the outcomes There may be huge emphasis on competition present in the market Need to subscribe to accreditation by more than one organization (PHF, 1997) In the year 2007, the Australian Commission on Safety and Quality in Health Care gave an alternate model for accreditation of healthcare organizations.   Consultation with the stakeholders helped to identify the deficiencies in the current system and to develop a better one.   The idea was to apply this new alternative accreditation system across all the sectors of healthcare in a phased manner. Characteristics of this new accreditation system: – Implementing certain reforms Bringing about certain standards in the Australian healthcare system The system was to be developed in association with the stakeholders Improve the quality standards Improve the compliance levels with the rules in the healthcare organization Ensure evidence-based practices Improve the monitoring system Support mutual recognition Improve the participation levels Improve the assessments levels, methods and surveys Obligations to be imposed so that the organization adheres to the standards (Australian Commission on Safety and Quality in Health Care, 2007). Conclusion – It can be said that the entire process of accreditation needs to be setup in such a way that emphasis is given only in improving the patient care and satisfaction. All the meaningless process and structures that do not have an effect over improving the patient care should be removed.   The accreditation organization should ensure that such a system of accreditation is practically applicable by various types of healthcare organizations.   Not much emphasis should be given on costs.   Even organizations that are providing cost-effective care and are meeting with reasonable standards should be provided accreditation.   Accreditation should also be a voluntary system and not a compulsory one.   Different levels of accreditation should also be provided (PHF, 1997).    References: Australian Council for Healthcare Standards (2007). â€Å"About US.† [Online], Available: http://www.achs.org.au/whatwedo/, [Accessed: 2008, March 17]. Australian Council for Healthcare Standards (2007). â€Å"Mission, vision and values.† [Online], Available: http://www.achs.org.au/missionvisionvalues/, [Accessed: 2008, March 17]. Australian Council for Healthcare Standards (2007). â€Å"What accreditation means.† [Online], Available: http://www.achs.org.au/whataccredmeans/, [Accessed: 2008, March 17]. Australian Council for Healthcare Standards (2007). â€Å"ACHS Position Statements.† [Online], Available: http://www.achs.org.au/positionstatements/, [Accessed: 2008, March 17]. Australian Commission on Safety and Quality in Healthcare (2007). â€Å"UPDATE: Review of National Safety and Quality Accreditation Standards November 2007.† [Online], Available: http://www.safetyandquality.org/internet/safety/publishing.nsf/Content/accreditation, [Accessed: 2008, March 17]. Australian Commission on Safety and Quality in Healthcare (2007). â€Å"Draft: An Alternatvie Model for Safety and Qualtiy Accreditation.† Barnes, A.M. (2001). â€Å"Healthcare Law: Desk Reference.† Ali-Aba. http://books.google.co.in/books?id=KS5xke6-DEgC&dq=accreditation+advantages+healthcare&source=gbs_summary_s&cad=0 JCAHO (2007). â€Å"Benefits of Joint Commission Accreditation.† [Online], Available: http://www.jointcommission.org/HTBAC/benefits_accreditation.htm, [Accessed: 2008, March 17]. JCAHO (2007). â€Å"PSP Fact Sheet.† [Online], Available: http://www.jcipatientsafety.org/fpdf/ICPS/PSP%20Fact%20Sheet%20with%20New%20Logo.doc, [Accessed: 2008, March 17]. Public Health Foundation (1998). â€Å"Accreditation: A Study of Issues and Characteristics Applicable to Public Health.† [Online], Available: http://www.phf.org/Reports/Accreditation1/final_report.htm, [Accessed: 2008, March 17].