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Running head: PEDIATRIC HEALTH PROMOTION 1
Pediatric Health Promotion
Emmah Kargbo.
NSG 200.
11/23/2020.
PEDIATRIC HEALTH PROMOTION 2
Pediatric Health Promotion
Health promotion refers to the approach integrated into the health care system to allow
people to increase control over, as improve their health. In that regard, health promotion
emphasizes more on environmental and social interventions than individual behaviour (Daley et
al., 2020). In this assessment, the client to be considered is Peter James, an 18-year-old male.
Peter is in the adolescent stage, and he has demonstrated several behaviours that depict that he
has met the developmental milestone of a person in the adolescent stage. For example, he
describes volatile emotions, develops a sense of independence, develops an interest in a romantic
relationship, develops a commitment to education, and spend a lot of time with his peers. In
other words, the client is mature in the sense that he can distinguish between right and wrong
when making judgments and decisions.
It is also essential to examine different developmental theories on human growth and
development based on the adolescent agent of the client. Some of these theories include Erick
Erikson theory, social learning theory, and Maslow Hierarchy of Needs. According to Erikson,
human personality changes in a predetermined order. Therefore, there are different stages of
psychosocial development that depict the development of a person from infancy to adulthood. In
each stage, the experience for each individual makes him or her face psychosocial crisis to
demonstrate personality development.
Erikson psychosocial theory has eight stages of development that explain changes in
different stages of human development. In this case, the client is 18 years old in the adolescent
stage. According to Erikson, the psychosocial stage for an adolescent is known as identity vs role
confusion (Gross, 2020). This is the 5th stage that Erikson uses to demonstrate how adolescent
PEDIATRIC HEALTH PROMOTION 3
develop based on their behaviours and other aspects. The stage mainly explores psychosocial
develop for persons aged between 12 to 18 years. As children transform to adulthood, this stage
is paramount in shaping their future in terms of roles in adulthood.
Moreover, Erikson considers this stage as “role confusion” because adolescents will see
changes in their body (Gross, 2020). They also become responsible when they develop both
mentally and physically, such that they explore different social roles. However, the 5th
psychosocial stage also focuses on the identity crisis that may affect adolescents as they
determine their identity. This explains why adolescents explore different lifestyles to understand
their real identity.
More importantly, the adolescent stage can be explored through Maslow’s Hierarchy of
Needs. Mainly, this theory consists of five components that demonstrate survival. The relevance
of this theory at the adolescent stage is the component at the bottom of the pyramid called “basic
needs” (Crandall et al., 2020). In that regard, adolescents require basic needs from their health,
growth, and development. Therefore, they require food for physical growth and mental
development. This theory also consists of “safe needs” that can be used in adolescent stage to
ensure they reside in a safe environment that will facilitate their transformation to adulthood.
Maslow’s theory also expresses the importance of “social needs”. These needs are
relevant in the adolescent stage because they require attention and love from parents, peers,
siblings, and the community. The “esteem needs” also influence the development of adolescents.
The environment for adolescents is determined by the impact of this component, especially when
making decisions. Overall, Maslow’s theory explores how “self- actualization” affects human
development (Crandall et al., 2020). It is relevant in the adolescent stage because they focus on
their identity in life.
PEDIATRIC HEALTH PROMOTION 4
The last theory that explores human development at the adolescent stage is the social
learning theory. This theory argues that people develop new behaviours through imitation and
observation. In that regard, adolescents can develop new behaviours by imitating other people by
watching what they do (Pringle et al., 2018). However, some behaviours achieved through social
learning theory can mislead adolescents. Therefore, it is paramount to guide them to ensure they
only observe and imitate the right actions.
Consequently, health promotion for a client at the adolescent stage is paramount and
proper communication is a crucial skill for completing the assessment. Therefore, at 18 years
old, the client can be distracted by many factors. It is essential to embrace effective
communication to ensure the client develop confidence, respect, and trust. It is also paramount to
ensure that client has consent about the assessment and assure him that data collected will be
handled with ultimate privacy and confidentiality (Daley et al., 2020). More importantly, it is
essential to inform the client the reason for asking personalized questions and how they help in
health promotion. The client can choose to be assessed in the absence of the parent to ensure they
fully open up without fear of intimidation and to promote privacy.
Client:
P J, is The client in the health promotion assessment. He is 18 years old. In the interview,
the client’s father will be present as an informant. It is also paramount to acknowledge that PJ,
completed the required documentation such as Guidelines for Adolescent Prevention Survey.
Health History:
Biographic Data:
The client, P J, is 18 years old. He was born on 14th November 2002 as an AfricanAmerican.
PEDIATRIC HEALTH PROMOTION 5
Reason for Seeking Care: Well Visit
History of Present Illness: The client has no record of depression.
Present Health Status: The client is taking antidepressants such as citalopram and escitalopram.
The client is also receiving cognitive behaviour therapy.
Past Health History: The client has no history of any medical condition. All physical
examinations for vision, immunization, dental health, and other requirements are up to date.
Family History:
Brother: 16 years old, asthmatic
Sister: 13-year old, type 1 diabetes
Father: 57 years old, Rheumatoid arthritis
Mother: 55 years old, Hypertension
Paternal Grandfather: 82 years old, type 2 diabetes
Paternal Grandmother: 78 years old, type 2 diabetes
Maternal Grandfather: 80 years old, stroke
Maternal Grandmother: 77 years old, Kidney failure
Person Status:
Client’s father describes him as “sharp, diligent, and intelligent”. During the interview,
the client was restless and lost concentration in the larger part of the interview. When asked
“what is going on?” He replied with a loud voice, “I am ok!” Then the client expressed sadness
and his mood changes almost immediately.
The client is the basketball captain in his school and has propelled his to best performance in the
last competition. However, the client indicated on the Guidelines for Adolescent Prevention
PEDIATRIC HEALTH PROMOTION 6
Survey, his plans to quit basketball because he lost interest in the game, despite being the best
player in the region.
Family and Social Relationships:
The client states that his relationship with his family is not good. Although his siblings
are the best, his father and mother engage in domestic conflict most of the times. His father is
violent, and the family faces domestic violence that affects the welfare of the family. The client
also claims that he spends most of his time with two close friends whenever his family has
domestic violence. The client also states he is a romantic relationship with a 17-year-old girl he
met in a piano training program in the community centre.
Diet and Nutrition:
The client does not like eating fast foods and prefers to eat food prepared by his mother at
home. He also likes eating organic vegetables and fruits for breakfast. For both lunch and dinner,
the client eats rice with fish and blended juice. The client stated in the interview that his organic
diet to help him lose body weight.
Sleep:
The client acknowledges that his sleeping pattern has changed in the last six months. He
states that sleep deprivation has affected his daily activities at school. Despite going to bed at 10
pm, the client expresses that his only sleep for 4 hours due to sleep deprivation.
Mental Health:
The client claims that for the past six months, his depression level has increased. He even
claims that suicidal thoughts have been haunting him for that period. He also experiences
sadness and mood swings. He claims that her depression is caused by domestic violence
PEDIATRIC HEALTH PROMOTION 7
experienced in his family. He also claims that basketball used to relieve his stress, but in the past
six months, the depression level has increased. He even decided to quit playing basketball.
Sexuality:
The client states that he started feeling attracted to girls at the age of 12 years. His male
reproductive organs are fully developed. Although he is in a romantic relationship with a girl, he
is not engaging in a sexual relationship. He is only attracted to the opposite sex, which means he
is heterosexual.
Development:
In terms of personal development, the Bright Futures Pre-Visit Questionnaire indicates
the following aspects of the client.
 He understands the importance of eating healthy food to prevent adverse impacts
associated with fast foods.
 He has great friends who support him whenever his family engages in domestic violence.
 He is excellent in co-curricular activities such as basketball.
 He is independent and makes personal choices.
 He is also excellent at playing the piano.
Health Promotion Activities:
The client plays the piano every evening as a way to control stress. He also played
basketball to improve his mental health. He does not abuse substances such as alcohol and
narcotic drugs.
Home Environment:
The home environment is safe, and only a few criminal activities are reported. The
environment is also clean, with no pollution identified in the area. Also, the public park is
PEDIATRIC HEALTH PROMOTION 8
excellent for physical exercise. His home is also equipped with sustainable water supply,
electricity, heating system during winter, and cooling system during summer.
General Survey:
The client has a black skin colour which demonstrates his African-American ethnicity.
He does not maintain eye contact and seems restless due to lack of concentration. There are signs
of acute distress and prefer spending time alone at school but only socialize with at least three
friends at home environment.
Vital Signs:
Temperature: 96.3 F, Oral
Blood Pressure: 115/70, Sitting
Pulse: 72 beats/min
Respiratory Rate: 15 beats/min
Weight: 76. 5 kg
Height: 60 inches or 1.524 meters
BMI: 32.94 kg/m2, he is overweight
Pain:
The client rated his pain level at 3. At 0, it indicates that there is no pain while 10 means
the worst pain. Therefore, at 3, the client was having moderate pain.
Analysis of Data:
Based on GAPS, health history interview, pre-visit questionnaire, general survey, and
vital signs, it is possible to determine the wellness of the client. First, the client claims that
domestic violence exposes him to depression. His BMI is high at 32.94 kg/m2, which indicate he
is overweight. He also expresses restless, lack of concentration, and sadness as signs of
PEDIATRIC HEALTH PROMOTION 9
depression. Therefore, the care plan involves addressing depression caused by domestic violence.
It is also essential to improve his BMI level to a normal healthy weight.
Nursing Diagnosis:
The client has chronic depression, as evidenced by suicidal thoughts as expressed by the
client.
Goal:
The goal involves engaging his parents to end domestic violence to ensure the client
experience an excellent home environment and family love.
Objective 1: The client identifies ways to improve mental health and implement them.
Objective 2: The client identifies strategies to reduce body weight and implement them.
Objective 3: The client should resume playing basketball to reduce stress and depression.
Interventions:
1. It is essential to encourage the client to engage in activities that reduce depression.
2. It is essential to engage the client through active listening to motivate him on how to
reduce depression.
3. Mainly, privacy and confidentiality should be considered when engaging the client.
4. His parents should be engaged to end domestic violence that affects the mental health.
Evaluation:
1. It is vital to review the journey when the client visits next time to determine if there is
any improvement.
2. The client can continue feeding on a healthy diet to manage his weight.
PEDIATRIC HEALTH PROMOTION 10
References
Crandall, A., Powell, E. A., Bradford, G. C., Magnusson, B. M., Hanson, C. L., Barnes, M. D., …
& Bean, R. A. (2020). Maslow’s Hierarchy of Needs as a Framework for Understanding
Adolescent Depressive Symptoms over Time. Journal of Child and Family
Studies, 29(2), 273-281.
Daley, A. M., Lestishock, L., & White, P. H. (2020). Pediatric Nurse Practitioners’ Perspectives
on Engaging Adolescents to Shift from Pediatric to Adolescent-Focused Health Care
Services. Journal of Pediatric Health Care, 34(6), 550-559.
Gross, Y. (2020). Erikson’s Stages of Psychosocial Development. The Wiley Encyclopedia of
Personality and Individual Differences: Models and Theories, 179-184.
Pringle, J., Doi, L., Jepson, R., & McAteer, J. (2018). Developing an evidence and theory based
intervention that seeks to promote positive adolescent health and education
outcomes. The Lancet, 392, S73.
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Women in the Scientific Revolution. The scientific revolution is generally considered part of the broader intellectual revolution that began with the Italian Renaissance and the rediscovery and translation of the classical writers, particularly Aristotle, sometime during the fourteenth century. It is only in retrospect that one can understand broad movements, such as this, but one can assert with confidence that the scientific revolution resulted from a confluence of several factors, most particularly the rejection of the Ptolemaic model of planetary movement combined with an increased interest in Aristotelian science (Grant, 1996). Thus, the scientific revolution, insofar as it was a “revolution” rather than a developing, continuous process, may be claimed to have begun in 1543 with the publication of Copernicus’ De revolutionibus orbium coelestium, though establishing this as a boundary is as much a matter of convenience as anything else (Linton, 2004). As an intellectual and cultural phenomenon, the scientific revolution continues to the present, moving through such advances as Newtonian mechanics, the experimental method of chemistry, advanced in anatomy and medicine, Darwinian evolution, relativity and quantum mechanics, with myriad offshoots at every stage along the way of this development. At the present, there is much dispute about how, or whether, the scientific revolution will end: some think it will continue forever, while others believe it will culminate with grand unification, a theory of everything that explains both gravity and subatomic forces, in effect capable of describing all phenomena (Westfall, 1971). That woman have played pivotal roles in the advancement of science is undeniable; as with male figures, it is possible to isolate selected examples of women who made significant contributions. There is no reason to believe that such contributions were made because of their gender, but given the nature of society at the time of the scientific revolution, one may assert that the contributions were made in spite of their gender. As the scientific revolution may be said to continue to the present day, so too, does the gender bias in the sciences, though there is evidence this is getting better. Women in the Scientific Revolution – Margaret Cavendish Perhaps Margaret Cavendish is the best example of such a woman in the midst of the scientific revolution. While biographies of her once concentrated on her eccentric behavior and the more florid aspects of her life (Grant, 1957, Whitaker, 2003), we are the beneficiaries of a recent flurry of scholarly interest in her philosophical and scientific undertakings. She engaged with, and apparently held her own against Thomas Hobbes, Robert Boyle, René Descartes and others in the early Royal Society, though she herself was denied fellowship in that exalted body (Walters, 2014). Margaret Cavendish rejected Aristotelianism and the mechanist philosophies that prevailed through much of that time, adopting a vitalist view instead, holding that living things are different from nonliving things in that they possess a spark of life that subjects them to different physical rules; this is now an obsolete scientific theory (Sarasohn, 2010). O’Neill in Cavendish (2001) characterizes Cavendish’s natural philosophy as an outright rejection of Aristotle while adopting stoic doctrines; O’Neill (2001) also notes that while women rarely wrote on scientific matters at this time, Margaret Cavendish published six scientific books, two of which are currently in print; it is also worth noting that Margaret Cavendish was a duchess and, as such, had certain social and economic advantages most other women would not have shared. Cavendish’s main scientific work was Observations Upon Experimental Philosophy (2001), written in the vernacular, rather than the Latin that was typical of scientific books until well into the nineteenth century, which itself reflects the scientific revolution’s origin in the Greek and Latin classics. She had already undertaken earnest study of contemporary scientific and philosophical works and this book of hers clearly shows the influence of Thomas Hobbes, who had instructed her brother Sir Charles Lucas in philosophy; in fact, she was one of the few of her time who accepted Hobbes’ ideas that incorporeal souls do not exist in nature (Sarasohn, 2010). She certainly expresses herself well in her book, even discussing in the preface whether her excessive writing is a disease (Mendelson, 1987), a question that still plagues modern practitioners (e.g., Flaherty, 2004). As she points out, she wrote primarily for herself and if it was a disease, then it was a wonderful disease suffered by Aristotle, Homer and Cicero, among others (Cavendish, 2001). Women in the Scientific Revolution – Maria Winckelmann In Germany, circumstances for women in science were different; few independently pursed their scientific interests. The astronomer Maria Winckelmann Kirsch is perhaps the best and certainly the best remembered example. She married the astronomer and mathematician Gottfried Kirsch and while they functioned as equals, the prevailing attitude of their time was that she was his assistant; Kirsch himself was a product of a scientific family and there is no reason to believe he did not appreciate his wife’s collaboration. In any event, we know she wrote of the conjunctions of the planets and, in 1702 became the first woman to discover a comet; she also published the most erudite observations of the aurora borealis to that time (Schiebinger, 1987). Unfortunately, Maria Winckelmann Kirsch has yet to benefit from a revival of scholarly interest in her life and activities that has benefited Margaret Cavendish. Women in the Scientific Revolution – Maria Gaetana Agnesi In Italy, traditionally regarded as the birthplace of the Renaissance, the situation for women was different still, and is best exemplified by Maria Gaetana Agnesi, who, like Margaret Cavendish, had the advantages of wealth and social position and also pursued her interests independently. Her father was a professor of mathematics at Bologna and Maria showed intellectual gifts from an early age (Osen, 1975). Throughout her life, he was a very religious person and constantly found herself in the verge of spiritual revelation; fortunately for the history of science, she was a person of rare intellectual energy and she undertook the study of calculus when that was still cutting edge mathematics. Her most important work is Instituzioni analitiche ad uso della gioventù italiana, which uncharitably translates to Analytic Institutions for Use by Italian Youths – an excellent introduction to Euclid and the first work to include both differential and integral calculus; in fact, Struik (1987) refers to her at the first important woman mathematician since Hypatia, some thirteen centuries before; Struik (1987) also calls this work the model for all subsequent calculus textbooks. As it was intended as a textbook for use by students, like Cavendish, Agnesi wrote in the vernacular Italian, and wrote very well, though lacked the Margaret Cavendish’s literary charm. Agnesi became a professor of mathematics at the University of Bologna, the first woman to achieve this, anywhere. As noted, she spent much of her life in religious contemplation, though it should also be noted that she devoted much of her she considerable wealth to helping the poor and infirm, to the point that she converted at least part of her home into a charity hospital. She was recognized in her lifetime and was praised by many, including Pope Benedict XIV, himself no intellectual lightweight (Mazzotti, 1987). If Maria Agnesi is remembered for anything now, curiously it is for something she did not discover: the Witch of Agnesi, a curve whose mathematical properties lie somewhat outside the scope of this paper. While others had previously considered this curve, Agnesi was the first to give it a rigorous analytical treatment in her textbook; that it is called a “witch” is the product of an unfortunate early mistranslation into English that stuck. The curve, however, has one property worth mentioning: it almost exactly resembles an isolated water wave (Mazzotti, 1987). These three are just examples of women who took part in the scientific revolution. There were many others worthy of mention and many others still whose contributions are either lost or unrecognized, in some cases, to this day. The Status of Women in Science Now It is safe to say that of all the scientists ever, an overwhelming percentage are professionally active now, and among there, there are more women than ever before. This notwithstanding, women face serious obstacles in the sciences. Statistics indicate that women do less well than men in terms of degree, tenure and salary. In a field such as nursing, that has traditionally been dominated by women, men hold four percent of the professorships; by contrast women have never held as much as four percent of the professorships in any field dominated by men; even in psychology, were women obtain the majority of doctorates, women do not yet fill the majority of professorships (Schiebinger, 2001). Even so, there have been many noteworthy women scientists at present. To cite just one such example, the American Barbara McClintock discovered the transposition of genes and this explained how certain physical characteristics are turned on or off (Comfort, 1999). For this, she was elected to the National Academy of Sciences in 1944 and in 1983 won the Nobel Prize in physiology or medicine and, in fact, remains the only woman to win that prize, unshared. There is some contention over the exact nature and precedence of her discoveries, but even her critics concede her pivotal role in genetics research (Comfort, 2001). Reducing Barbara McClintock and her contributions to a single paragraph is hardly fair to her, or to women in science today. It is, however, important to recognize that woman have made important contributions to science from the earliest times and while many of these contributions remain unrecognized, this is finally being addressed. Given current demographic and educational trends, it is clear that the influence of women in science will only increase with time. Conclusion As noted, women have played important roles in science from antiquity to the present, though their roles and their contributions have often been lost or gone unrecognized. This paper has examined three such figures from the time of the scientific revolution, as well as one from the postwar era in the United States to demonstrate that their contributions can be meaningful and as important as those of their male counterparts. It is to be understood that if science is to be a truly democratic and fair institution, it must welcome contributions and criticism from everyone and while tremendous strides have been made, the institution of science as a whole still has a long way to go to achieve this egalitarian goal. References Cavendish, M. (2001). Observations upon experimental philosophy. E. O’Neill (ed.). New York, NY: Cambridge University Press. Comfort, N. (1999). “The real point is control”: The reception of Barbara McClintock’s controlling elements. Journal of the History of Biology, 32 (1): 133–62 Comfort, N. (2001). The tangled field. Cambridge, MA: Harvard University Press. Flaherty, A. (2004). The midnight disease: The drive to write, writer’s block, and the creative brain. New York, NY: Harcourt Brace. Grant, D. (1957). Margaret the first: A biography of Margaret Cavendish Duchess of Newcastle 1623–1673. Toronto, ON: University of Toronto Press. Grant, E. (1996). The foundations of modern science in the Middle Ages: Their religious, institutional, and intellectual contexts. New York, NY: Cambridge University Press. Linton, C. (2004). From Eudoxus to Einstein: A history of mathematical astronomy. New York, NY: Cambridge University Press. Mazzotti, M. (2007). The world of Maria Gaetana Agnesi, Mathematician of God. Baltimore, MD: The Johns Hopkins University Press. Mendelson, S. (1987). Margaret Cavendish, Duchess of Newcastle. In The mental world of three Stuart women. Brighton, UK: Harvester, pp. 12–61. Osen, L. (1975). Women in Mathematics. Cambridge, MA: MIT Press. Sarasohn, L. (2010) The natural philosophy of Margaret Cavendish: Reason and fancy during the scientific revolution. Baltimore, MD: The Johns Hopkins University Press. Schiebinger, L. (1987). Maria Winckelmann at the Berlin Academy: A turning point for women in science. Isis, Journal of the History of Science Society, 78 (292): 174–200. Schiebinger, L. (2001). Has Feminism Changed Science? Cambridge, MA: Harvard University Press. Struik, D. (1987). A Concise history of mathematics (4th rev. ed.). New York, NY: Dover Publications. Walters, L. (2014). Margaret Cavendish: Gender, science and politics. New York, NY: Cambridge University Press. Westfall, R. (1971). The construction of modern science. New York, NY: John Wiley and Sons. Whitaker, K. (2003). Mad Madge: Margaret Cavendish, Duchess of Newcastle, royalist, writer and romantic. London: Chatto and Windus. Women in the Scientific Revolution
‘The process of medication use is a continuum of activities involving multiple health care professionals and multiple steps (that is, prescribing, transcribing, dispensing, administering, and monitoring), thereby creating multiple opportunities for error’ (Zhan et al., 2006, p353). The principle aim of this essay will be a critical analysis of the management of medicines by nurses in the hospital environment in order to avoid medical errors and their possible adverse affects on patients. The prevalence, types, causes, sources and some consequences of medication errors will also be discussed. In order to provide a foundation for exploring these issues, definitions of medical error and related terms will be expressed. Types of medical errors originating in four sources, namely nurses, patients, doctors and pharmacists, will be discussed, as they may be severally, or individually, responsible for a medical error. Reference will be made to five personal observations of potential medical errors of nurses whilst I was on recent clinical placements; these observations will form the central focus of the essay. Strategies will be outlined for reducing potential medical errors associated with these five observations, using evidence-based practice and relevant government policies. Medication errors associated with two high risk medicines, namely potassium chloride and insulin, will also be examined, together with strategies and protocols designed to reduce their potential danger. Finally, the importance of team work, reflective practice, good communication, and the need to overcome barriers in reporting medical errors by nurses will be emphasised. Most medical errors do not harm patients (DoH, 2004). However, the National Patient Safety Agency (NPSA) (2009a) reported 3,426 medication incidents in Wales and that 1-2% of these incidents led to harm or death in the National Health Service (NHS) during the period April 2008 to March 2009; 32 medication incidents caused severe harm and 6 medication incidents caused death. In England, over the same period, the NPSA (2009b) reported that less than 1% of all incidents leading to harm or death in the NHS were due to medication errors; 155 medical incidents caused severe harm and 42 caused death. In order to understand medication errors and discuss strategies for reducing medication errors, it is useful to understand the terms ‘medication’, ‘medication error’, ‘adverse drug event’, and also to classify types of error. A medication is a compound which is taken or administered for one or more of the following reasons: ‘to prevent a disease, to modify a physiological, biochemical, or anatomical function or abnormality; to replace a missing factor; to ameliorate a symptom, to treat a disease; to reduce anaesthesia’ (Aronson, 2009, p601). A medication error can be defined as ‘a failure in the treatment process that leads to or has the potential to lead to, harm the patient’ (Aronson, 2009, p599); the ‘treatment process’ is a complex process that includes prescribing, dispensing and administration of a drug. This definition does not indicate whether the error is due to a doctor, pharmacist, nurse, patient, or other person. Medication errors should not be confused with adverse drug reactions (ADRs), although the two terms may overlap (Britten, 2009). An ADR has been defined by Bowman et al. (1996) as ‘any adverse experience associated with the use of the drug including any side effect, injury, toxicity, sensitivity or reaction’ (p10). The term ‘adverse drug event’ (ADE) is sometimes used for a medication error; an ADE includes human factors such as delay in administration, accidental overdose, or incorrect medication (Hendrie et al., 2007). ADEs may be linked by their intrinsic toxicity (inherent adverse effects) or by their extrinsic toxicity, that is, the way the drug is used; examples of extrinsic toxicity include interactions between two or more drugs or drug-food interactions (Guchelaar et al., 2005). According to psychologists, errors may be classified as ‘mistakes’ (knowledge-based or rule-based errors), ‘slips’ (observable action-based errors such as the slip of pen or technical error) or ‘lapses’ (non-observable memory-based errors); a slip or lapse occurs when the action conducted is not what was intended (Reason,1990, p54), for example, an intention to write a prescription for 100mg of a drug, but writing 300mg instead (DoH, 2004). The disadvantage of this type of classification for medication errors is that it focuses on human rather than systems sources of errors (Aronson, 2009). The causes of medication administration errors by nurses may be viewed as ‘person’ or ‘system’ based (Tang, et al., 2007). The ‘person’ approach to medication errors is the prevailing approach in medicine and is directed to ‘aberrant mental processes such as forgetfulness, inattention, poor motivation, carelessness, negligence, and recklessness’ (Reason, 2000, p768). Attaching blame to an individual for unsafe behaviour is easier than targeting an organisation (Reason, 2000). The basic principle of the ‘system’ approach is that humans are prone to err, and errors are due to ‘error traps’ and ‘organisational processes’ in the workplace. Errors committed by individuals are transmitted through ‘holes’ in the layers of ‘defences, barriers, and safeguards’ of an organisation; these layers with their holes are analogous to the holes in slices of Swiss cheese (Reason, 2000). The presence of holes in a single layer does not normally lead to an error, but if the holes are lined up for a brief moment, there is an opportunity for an error to follow a trajectory through a faulty system and cause damage to a victim. Reason (2000) contended that adverse events usually involve a combination of ‘active failures’ by individuals and ‘latent’ factors in the working environment. ‘Active failures’ include forgetting or ignoring an established policy or procedure, whilst ‘latent’ factors include staffing shortages, inadequate equipment and lighting (Brown, 2000). The DoH (2004) guidelines for reducing medical errors stress that the following checks should be performed prior to medication administration: ‘right medication, in the right dose, to the right person, by the right route, at the right time’ (p61). Crouch and Chapelhowe (2008) also concurred with adherence to these ‘five rights’ in medicine management. However, rule-based administration of medicines using the ‘five rights’ may lead nurses to act ritualistically, and give a false assurance that their practice is safe (Crouch and Chapelhowe, 2008). Deviations from the ‘five rights’ of medicine administration were elaborated in an extensive literature review of 26 studies by Brady et al. (2009). In one study, violations of the ‘five rights’ by 72 nurses in a Taiwanese hospital were reported by Tang et al. (2007); these were wrong dose (36.1%), wrong drug (26.4%), wrong time (18.1%), wrong patient (11.1%) and wrong route (8.3%). The main factors contributing to medical errors by nurses were personal neglect (86.1%), and ‘systems-based’ factors such as heavy workload and new staff. The main limitations of this study were the relatively small sample size and the limited experience of the nurses (average of two years). Administering medications is prone to error since it is ‘more than a technical mechanical process’ (Eisenhauer, 2007, p86). Concurring with this view, Crouch and Chapelhowe (2008) stated that safe medication is a ‘psychomotor skill’ and requires: ‘cognitive skills such as observation, listening to patients, analysis, critical judgement, clinical judgement, decision making, teaching and interpersonal skills’ (p 487). Judgment is needed in dosage, timing, selection of specific medications, checking on a patient’s laboratory data (for example, potassium or blood glucose levels), observing and responding to adverse drug events, and deciding when to stop medication if adverse effects occur (Eisenhauer, 2007). Safe medication is dependent on nurses acquiring motor skills using advanced technology to deliver medicines by a variety of routes, (for example, hypodermal, intramuscular, intravenous and patient controlled analgesia) and using different types of pumps, tubes and valves; such complexities have increased the risks of inappropriate dosing and wrong route (Sheu, et al., 2009; Tang et al., 2007). During recent clinical placements in the hospital environment I observed five potential sources of error in the administration of medicines by nurses: these were poorly prepared, untidy and unattended drug trolleys, interruptions during nurses’ drug rounds, unsafe patient self-medication, and complex activities involved in intravenous medication and drug calculations. These five potential sources of error I observed will now be examined in turn. The first example of a potential source of error I observed was poorly prepared, unattended and untidy drug trolleys; these have the potential to lead to errors in administering medicines accurately and safely to patients (DoH, 2004; Castledine, 2006; Palese et al., 2009). Medicine trolleys are commonly too small and poorly designed for holding an ordered arrangement of diverse medications and related medical equipment; furthermore, identification of medicines by nurses is subject to error, since all labels are white, and medicines often have similar sounding names, for example, penicillin (an antibiotic) and penicillamine (an anti-inflammatory drug) (Crouch
Update from previous submission – see attached. I’m studying for my Management class and need an explanation.

Update your working document from Unit 3
You will add the following sub-project plans to your MS Word project management plan document from Unit 3:

Quality Management Plan: List which project deliverable s you need to ensure quality for and how you will do so. This section should be specific to your project, and it should cover the 3 quality management process components: Plan Quality Management, Manage Quality, and Control Quality.
Resource Management Plan: This section should include details on how you will acquire, develop, manage, and control your project resources.
Project Communications Management Plan: In a table format, create a communications management matrix and include with whom you will communicate, what you are going to communicate with them about, how often, and via what means (include other details as you see fit).
Risk Management Plan: In a table format, create a Risk Register (in Excel or Word) showing risk ID, risk name, description, risk category, impact, probability, trigger(s), risk owner(s), and risk response plan. You will need to show at least 8 negative and positive risks.
Procurement Management Plan: Remember, the software has already been purchased. So unless you will contract a third party or purchase additional equipment, this section should be limited to how you will acquire your project human resources. Include how you will plan procurement management, conduct procurement, and control procurement s.
Stakeholder Management Plan: You already created a Stakeholder Register; in this section, define how you will manage stakeholder engagement and expectations.In one cohesive document should address project closure. This should include the following:

Create a project closure section with all the necessary closure actions including:

Making certain all project documents are up-to-date
Formal approvals of all the project deliverables
Reassigning project personnel
All costs have been charged
All contracts have been satisfied and contractors have been paid and released
Feedback gathering and lessons learned
Transfer product or result to operations or another team
Archive project records
Celebration of success

Update from previous submission – see attached

Review the available literature regarding the sustainability of solution-focused therapy.

Review the available literature regarding the sustainability of solution-focused therapy..

Review the available literature regarding the sustainability of solution-focused therapy. Select a position either for or against the use of solution-focused therapy.Write a 350-500-word essay that includes the following:A description of your opinion for or against the use of solution-focused therapyDetailed rationale for your decision.Support your argument with at least two academic references. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center.
Review the available literature regarding the sustainability of solution-focused therapy.

Walden University Qualitative Studies & Ethnographic Studies Learnings Questions

essay help online Walden University Qualitative Studies & Ethnographic Studies Learnings Questions.

Review the work that you have done in the last two weeks, making sure that each cell in the matrix is completed.
Create your reference list, including books and methodological articles on each area. You can use the ones listed in the Learning Resources and search for your own as well.
Write a 2- to 3-page narrative. In your narrative, be sure to respond to the following:
Summarize what you have learned about the similarities and differences among the approaches.
Describe how what you’ve learned by developing the matrix has allowed you to choose the approach that you plan to use for your research plan in this course.
Identify the approach you intend to use for your research question.
Describe your rationale for your choice of approach.
Walden University Qualitative Studies & Ethnographic Studies Learnings Questions

JMU Does the Organizational Structure Assist with Solving the Problem Case Ques

JMU Does the Organizational Structure Assist with Solving the Problem Case Ques.

Section Two: Managerial Functions • 
How might the manager utilize the four functions to solve this issue/problem? 
a. Planning: What planning methodologies could be used to address the challenge? Are there any stakeholders that affect the issue at hand? Is there a certain strategy being utilized?
b. Organizing: Does the organizational structure assist with solving the problem? How does the organization manage change? Is the organizational culture helping or hurting the manager with the issue? How is decision making utilized by the manager? c. Leading: What specific managerial/leadership skills could assist with solving 
JMU Does the Organizational Structure Assist with Solving the Problem Case Ques

SDSU Cloud Computing & The case for Cloud Computing Credibility in Writing Discussion

SDSU Cloud Computing & The case for Cloud Computing Credibility in Writing Discussion.

How you complete this 2-page paper:Find two samples of professional or academic writing from your major or your field. A scholarly journal article would work, a syllabus from one of your classes, other course materials, or other kinds of writing (NOT WRITTEN BY YOU) that represent a more professional voice, more sophisticated (industry related) subject matter, etc. These should not be very difficult to find.Provide the titles of these documents in a short introduction to this 2-page analysis.You don’t need to post the samples. The main assignment: please write a 2-page, double-spaced analysis of how these authors establish credibility as seen in the writing and use of language and syntax. This should be a focus on the sentence-level writing (syntax, active voice, etc.) as well as the use of language and other conventions authors use to establish their ethos or credibility. Please refer to this week’s documents I discuss in the weekly lecture: “Teaching the Conventions of Academic Discourse” and the website from Lumen Learning. These two sources are found under our Writing Unit Readings. This is a 2-page analysis incorporating BOTH samples and BOTH sources. You can provide a short introduction for the reader but then discuss the ethos via the writing strategies used in these documents. Make ~4 specific references (note the reference, cite it in your writing) to the two sources (“Teaching the Conventions . . .” and Lumen Learning).You do not need a Works Cited page.
SDSU Cloud Computing & The case for Cloud Computing Credibility in Writing Discussion