Global Supply Management

Global Supply Management As businesses becomes before and more aligned to a completely global mode of operations, many organisations representing a number of disparate industries, including manufacturing, service, public service, social enterprises, NGOs, pharmaceuticals, food service and construction firms now run their businesses using a network of global suppliers.Advertising We will write a custom essay sample on Global Supply Management specifically for you for only $16.05 $11/page Learn More Operating a global supply chain has become a highly efficient means by which a company can boost profitability through streamlining production, reducing labour costs, minimizing the expense of equipment, cutting down on transportation and delivery costs and decreasing transit duration between suppliers, firms and customers (Bloom Kotler 1975; Cook 2011; Edgell, Meister Stamp 2008; Fisher 2011; Lloyd 1996; Porter 1985; Saxena 2010; Stauffer 2003). For the purposes of this paper, a supply chain refers to a group of three or more units, organisations or persons directly concerned with providing, manufacturing or producing the upstream and downstream current of services, information, parts, products or funds from a resource to a client (Cook 2008; Edwards 2006; Kelley Nagel 2007; Porter 1985). The following paper will critically evaluate the strategic rationale for why organisations might choose to use global suppliers from these so-called high risk regions, particularly when there might be less risk in using local supply chains, as well as the impacts that natural phenomenon and political unrest might have upon these types of global logistics and supply chain management strategies. The paper will also offer some strategies as to how to mitigate the impact of instability in the global supply chain. Strategic Rationale Part A of this paper discusses the strategic rationale as to why an organisation might choose to use a global supplier from a high risk region when less risk might be incurred using a supplier closer to home. Logic would dictate that if the home region of a global supplier is undergoing political turmoil through a transition in government leadership, terrorist activity, or if it was recently hit with a major natural disaster such as an earthquake or tsunami, the firm may be best served to move and transfer its interests from a regional supplier to a supplier in a safer part of the world, one in which the government appears stable, no major protests are underway, and where the climate is not prone to hurricanes and the like.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Typically, the first and most logical strategic response to this question is based in cost. Specifically, how much does it cost to move, versus how much does it cost to stay? The answer to this question will also depend on where the company is in terms of setting up its global supply chain, whether at the beginning of the process or well into it, what the function of the particular unit of the global supply chain in the overall upstream and downstream flow of the business is, the level of diversification that already exists within the global supply chain, and how long the company has based its operations in that particular region (Burke Cooper 2008; Cross 2007; Griffin 2008; Giermanski McGhee 2007; Glisson, Milton Jones 2009). Now that recent world events have illuminated the â€Å"inverse relationship between risk and efficiency [and] cast [it] in high relief, supply chain managers realize that they can no longer focus solely on cost reduction- any calculation of a supply chains return on investment must also take customer satisfaction into account† (Stauffer 2003, par. 4). However, cost remains the main driver of business decisions, and where global supply chains are concerned, if a company has already invested millions in a reg ional supply chain, cost becomes the number one factor. A company that has set up a global supplier in a region that was initially stable for many years and has become fractious over time must weigh the cost of moving its operations to a safe zone, and this weighing of costs must be applied to both short term and long term business goals. Similarly, a company that that has set up a global supplier in a region that was recently hit by a natural disaster must weigh the costs of moving its operations as opposed to staying in the affected region and repairing the damaged infrastructure. In global supply chains, it is the â€Å"integration of business processes, not individual functions, that creates value for customers and these processes reach beyond the boundaries of the firm† (Altay Ramirez 2010, p. 59).Advertising We will write a custom essay sample on Global Supply Management specifically for you for only $16.05 $11/page Learn More In this regard, even if the individual function – in this case, the unit of the global supply chain that has been threatened by terrorists or has been hit by a natural disaster – is temporarily out of commission or under threat, the company may decide that the unit fits too well into its overall integrated business model to change. A number of the most successful firms in the world have been operating global supply chains for many years and as such have built up strong networks, strong relationships and strong financial incentives in the global regions where they operate elements of their supply chains. As the leadership of any company can attest, networks, relationships and mutually enhancing financial incentives take years and years to build, and the idea of starting all over in a new region where the company will be one of many competitors bidding on the same parcel of land or negotiating with little or no personal leverage is simply too expensive a proposition to risk for many com panies. Also, strategically speaking, natural disasters tend to be short term problems. While they do cause massive amounts of damage, they do not happen annually; thus, a company may decide that in the long term expenditure, it will be cheaper and more prudent to repair the damaged infrastructure and remain in the region rather than incur the enormous cost of moving operations and setting up operations in a new location. Finally, labour costs continue to factor significantly into the strategic rationale applied when managing a global supply chain. Political unrest may be a small price to pay when faced with a jump in labour costs that will number into the millions for a globally integrated firm. Other strategic factors that may prompt firms to remain in politically unstable regions or regions prone to natural disasters include the degree of skill manifested in the labour force, tax incentives, beneficial rates of currency exchange and the efficiency of transport infrastructure such as ports (Bloom Kotler 1975; Cook 2011; Edgell, Meister Stamp 2008; Fisher 2011; Lloyd 1996).Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Risk management is the second element of the strategic rationale, and again, this equates to long term and short term business goals. As Stauffer (2003, par. 7) notes, risk can be seen as the sum of â€Å"frequency times consequencea high-frequency/low-consequence event, such as the regular fluctuation of currency exchange rates [is] similar to a low-frequency/high-consequence event, such as the sinking of a cargo ship laden with critical parts†. However, risk management varies widely from firm to firm, and also varies widely according to industry. An example is the recent earthquake in Japan. As the well-established â€Å"epicenter of high-tech manufacturing,† when the earthquake hit it affected the high tech industry to a much greater degree than other industries, because the vast majority of the major high tech firms use suppliers in Japan as part of their global supply chain (Fisher 2011, par. 2). In addition, depending upon the particular firms tolerance for risk, such â€Å"apparently similar risks can have vastly different qualitative effects† (Stauffer 2003, par. 7). Risk tolerance and risk management will also depend largely on corporate culture, the liquidity of the company, its insurance strategies and capabilities and the type of industry. Most importantly, risk management can be best served by a highly diversified global supply chain (Jà ¼ttner Maklan 2011). One of the ways that companies incur greater risk is through amassing a large portion of its suppliers for one particular part or service in one region (Belzer Swan 2011; Jà ¼ttner Maklan 2011). The ensuing clustering effect of global suppliers all located in one geographic region â€Å"can have serious consequences in the event of a natural disaster or political unrest† (Stauffer 2003, par. 7). Firms that operate global supply chains are well advised to diversify as much as possible. For example, rather than have one part sourced from one region, the firm can have it sourced from two or three regions in different parts of the world. Cost savings can be tweaked via reduced labour costs, tax incentives and currency rates, and the main benefit to global firms is that the â€Å"supply chain can insulate [the company] against shortages and other unpredictable problems† such as natural disasters or terrorism (Fisher 2011. par. 3). Finally, the third element of the strategic rationale is a question of trade-offs. Trade-offs transcend the basic reduce cost at all cost model of global supply chain management. For example, if the trade-off to operating in a region where the labour costs are the lowest in the world means that the company undergoes regular bombings from terrorist groups, the savings in labour costs may be eaten up by the expense of continually repairing or upgrading infrastructure, hiring additional security or implementing costly and complex firewalls and network security protocols. Trade off thinking goes along way toward a dopting a strategic global supply chain policy that allows for flexibility, agility and the constant streamlining of processes while keeping costs reasonable and continuing to increase profitability. Impacts of Natural Phenomena and Political Unrest Part B of this paper discusses some of the impacts that natural phenomena such as tornadoes and tsunamis as well as political unrest might have upon these types of global logistics and supply chain management strategies. The aforementioned definition of global supply chain points to a key component of the successful global supply chain, namely, the â€Å"direct link between the companies in a supply chain† (Altay Ramirez 2010, p. 59). Numerous supply chain management studies indicate that one of the pivotal indicators of success in a global supply chain rests on the realization that a global supply chain represents an assembly of interdependent parties; therefore, coordination and management of the global supply chain must always be a strategic response to the problems that emanate from the inter-reliant units within the chain, and the chain must always be viewed from a holistic perspective (Altay Ramirez 2010; Bakshi Kleindorfer 2009; Claessens Schmukler 2007; Perry 2007; Sarathy 2006). As a cohesive, integrated business unit, direct threats to the supply chain will be felt all the way through it. Thus, it is incumbent upon those responsible for global supply chain management to understand their charges as interconnected entities rather than isolated processes, as this attitude will likely build resiliency within the supply chain and bolster its ability to weather threats from both natural and human disasters (Fisher 2011; Jà ¼ttner Maklan 2011; Sheffi 2001; Stauffer 2003; Suder 2006; Wechsler 2011). The locations of these global suppliers are sometimes found in regions of the world that historically can be prone to the impact of natural phenomenon such as earthquakes, hurricanes or typhoons, flooding , tsunamis, and most recently, political unrest through the removal of traditional government regimes in certain countries as well as ongoing terrorist activities and threats, both real and perceived. Natural phenomena such as wildfires, earthquakes and floods can produce major disturbances in global supply chains, as they impede business operations and reduce the producing capacity of the companies doing business in the region that the natural disaster strikes (Altay Ramirez 2010; Alternate supply: disaster in Japan forces manufacturers to look elsewhere 2011; Belzer Swan 2011; Burke 2005). These regions of the world and the suppliers situated there would arguably present high levels of strategic risk for any organisation choosing to design their supply chain landscapes involving these areas. As Stauffer (2003, par. 2) notes, â€Å"terrorist strikes, political instability in Third World countries, and last years shutdown of West Coast shipping docks- have awakened managers as ne ver before to supply chain risks, some of which had been introduced or heightened by the very actions companies had taken to drive costs out of their supply chains†. Natural disasters have the power to harm or destroy infrastructure, interrupt supply chains and ultimately have an effect upon the profitability of the business as a whole, and natural disasters tend to affect all the elements within an existing supply chain (Altay Ramirez 2010). When a natural disaster occurs, â€Å"gaps in supply chain security hamper the safety and security of freight transport†¦this risk increases the deeper in the hinterland it originates† (Belzer Swan 2011, p. 41). The impact of a natural disaster on a global supply chain will differ according to the type of business as well as the type of natural disaster; therefore, different natural disasters may leave certain supply chains unscathed, whereas others will be completed obliterated. For example, in their 2010 study, Altay and R amirez (2010, p. 60) discovered that â€Å"the damage by windstorms and floods seem to be dramatically different from that of an earthquake, providing evidence against the all-hazards approach†. What the literature appears to be telling supply chain managers is that natural disaster do not come in cookie-cutter parcels that can be easily insured against, planned for or avoided; each one is different, and each one will have a different impact on the supply chain network (Holbrook 2011; Ngoctran 2011). For example, Altay and Ramirez (2010, p. 60) demonstrated that the â€Å"impact of floods on total asset turnover of a firm is dependent on the firms position in the supply chain. We found that while upstream partners enjoy a positive impact, downstream partners have to plan for the opposite†. What this means is that the impact of a natural disaster will be specific and not localized to the region it affects. Rather, the disaster will affect all the links in the chain. Thu s, â€Å"a supply chain-wide mitigation strategy rather than a company-specific one† appears to be the most efficient and pragmatic approach to natural disasters for supply chain managers to adopt (Altay and Ramirez 2010, p. 60). There also appears to be an inverse relationship between the complexity of a given global supply chain and the cost that a natural disaster will exact on the network (Altay Ramirez 2010; Gad-el-Hak 2008; Haight 2003). This is less true of political unrest. Political unrest and terrorism differs significantly from a natural disaster in that the latter tends to happen once, whereas the former can easily become chronic. Political unrest and terrorism can drag on for years, and the costs involved in hiring more security personnel, beefing up web security, hiring the IT expertise necessary to combat cyber terrorists, and repairing equipment or work spaces damaged or destroyed by terrorist activities can bleed the company for years at a time. Political un rest that occurs during a change in leadership can also prove expensive for a company operating a complex global supply chain, particularly if the political regimes are corrupt. In addition, unrest of a politicized religious nature can often lead to additional costs to the company if the new regime demands that employees take time out of their work day for religious activities. Terrorism in particular can have a long term impact on the financial stability of the firm, and this varies from industry to industry; however, as a rule, investment and access to capital tend to wane in politically charged environments (Jà ¼ttner Maklan 2011; Sheffi 2001). This occurs for both logical and emotional reasons. In a region dominated by terrorist activity, investors will fear for their investments more so than in a region where there is no terrorism. Terrorism by nature invokes fear, not simply for financial investment for personal safety as well; therefore, a region dominated by terrorism quic kly becomes a no-fly zone for investors, and this can lead to reduced capital for firms. This in turn affects a firm’s ability to grow. As a result, over time regions where terrorism persists will witness an exodus of many firms, as once the problem of terrorism takes root it quickly becomes chronic and difficult to root out. Global supply chain management involves a delicate touch and a holistic framework. Firms that grow to comprehend the â€Å"depth of their supply chains and critical dependencies† are the firms that tend to succeed over the long term (Fisher 2011, par. 12). Cost, while ultimately the main driver of most major business decisions, cannot be the only consideration in global supply chain management. Where natural disasters and political unrest are concerned, there is no such thing as a one size fits all plan that will insulate a supply chain. Each natural disaster is different and will affect the chain differently. A firm that employs a strategic respo nse to each natural disaster such as building in more suppliers and incorporating both geographic and political diversity among their suppliers will be far more likely to weather the storm. Reference List Altay, N, Ramirez, A 2010, ‘Impact of disasters on firms in different sectors: implications for supply chains’, Journal of Supply Chain Management, vol. 45 no. 4, pp. 59-102. ‘Alternate supply: disaster in Japan forces manufacturers to look elsewhere’, 2011, Industrial Engineer, vol. 10, pp. 5-12. Bakshi, N Kleindorfer, P 2009, ‘Co-opetition and investment for supply-chain resilience’, Production and Operations Management, vol. 18, no. 6, pp. 583–603. Belzer, M Swan, P 2011, ‘Supply chain security: agency theory and port drayage drivers’, Economic and Labour Relations Review, vol. 22 no. 1, pp. 41-55. Bloom, P Kotler, P 1975, ‘Strategies for high market share companies’, Harvard Business Review, November, p p. 63-72. Burke, R 2005, ‘International terrorism and threats to security: implications for organizations and management’, Disaster Prevention and Management, vol. 14 no. 5, pp. 639-643. Burke, R Cooper, C 2008, International terrorism and threats to security: managerial and organizational challenges, Northampton, Massachusetts, Edward Elgar Publishing. Claessens, S Schmukler, S 2007, ‘International financial integration through equity markets: which firms from which countries go global’, Journal of International Money and Finance, vol. 26, pp. 788-813. Cook, T 2008, Managing global supply chains: compliance, security and dealing with terrorism, Boca Raton, Florida, Taylor Francis. Cook, T 2011, Compliance in today’s global supply chain, Boca Raton, Florida, CRC Press. Cross, C 2007, ‘Studies in survival: future supply chains are growing in a laboratory’, Industrial Engineer, August, pp. 44-49. Edgell, J, Meister, G Stamp, N 2008, â €˜Global sourcing trends in 2008’, Strategic Outsourcing: An International Journal, vol. 1 no. 2, pp. 173-180. Edwards, J 2006, ‘Thinking inside the boxes: global supply chains must now address government logistics mandates, a post-9/11 legacy that is only becoming more complex’, CFO, The Magazine for Senior Financial Executives, vol. 8 no. 1, pp. 81-96. Fisher, D 2011, Japan disaster shakes up supply-chain strategies. Web. Gad-el-Hak, M 2008, Large-scale disasters: prediction, control and mitigation, New York, Cambridge University Press. Giermanski, J McGhee, M 2007, ‘How SOX and C-TPAT: impact global supply chain security’ Strategic Finance, April, pp. 33-43. Glisson, L Jones, K 2009, ‘Homeland security vs. cabotage: issues of terrorism or ploys’, Journal of Transportation Management, vol. 12, pp. 35-45. Griffin, W 2008, ‘The future of integrated supply chain management utilizing performance based logistics’, Defense A R Journal, vol. 15 no. 1, pp. 3-11. Haight, B 2003, ‘The perils of supply chain management: experienced veterans share their techniques and solutions to a more efficient supply chain’, Automotive Industries, August, pp. 24-32. Holbrook, E 2011, ‘A supply chain unlinked’, Risk Management, May, pp. 32-43. Jà ¼ttner, U Maklan, S 2011, ‘Supply chain resilience in the global financial crisis: an empirical study’, Supply Chain Management: An International Journal, vol. 16 no. 4, pp. 246-259. Kelley, E Nagel, T 2007, ‘The impact of globalization on structuring, implementing, and advising on sourcing arrangements. Georgetown Journal of International Law, Spring, pp. 619-632. Lloyd, B 1996, ‘The outlook for globalisation’, Leadership and Organization Development Journal, vol. 17 no. 1, pp. 18-23. Ngoctran, A 2011, ‘The Vietnam case: workers versus the Global supply chain’, Harvard International Review, vol. 33 no. 2, pp. 60-81. Perry, M 2007, ‘Natural disaster management planning; a study of logistics managers responding to the tsunami’, International Journal of Physical Distribution Logistics Management, vol. 37 no. 5, pp. 409-433. Porter, M 1985, Competitive advantage: creating and sustaining superior performance, New York, Simon Shuster. Sarathy, R 2006, ‘Security and the global supply chain’, Transportation Journal, vol. 45 no. 4. pp. 28-34. Saxena, R 2010, ‘Define logistics, Industrial Engineer, vol. 11, pp. 24-26. Sheffi, Y 2001, ‘Supply chain management under the threat of international terrorism’, The International Journal of Logistics Management, vol. 12 no. 2, pp. 1-11. Stauffer, D 2003, Supply chain risk: deal with it. Web. Suder, G 2006, Corporate strategies under international terrorism and adversity, Northampton, Massachusetts, Edward Elgar Publishing. Wechsler, J 2011, ‘FDA promotes innovation, access to medicines while moderni zing operations’, Formulary, December, pp. 550-611.

VARK Questionaire Assignment Example | Topics and Well Written Essays - 500 words

VARK Questionaire - Assignment Example Training would include putting concepts into various illustration formats so that the individual could see a pictorial representation of the subject matter. In opposite accord, the aural learner would best be assisted in comprehension by putting training material into the form of a lecture or using CD-ROM technology with auditory discussion of subject matter. This would allow the aural learner to focus more intently on the concept or lecture. For those with read/write as their preferred style, the training should include textbooks, notes and other various hand-outs that describe the learning concepts. This type of learner would benefit from having subject outlines written or certain lecture notes that have been properly paraphrased and put into documentation (Murphy, et al.). The kinesthetic learner prefers a more hands-on approach, a form of experiential learning. This is a learn-by-doing approach which could involve role playing in groups or developing hands-on science projects and experimentation to come up with a concept solution (Pashler, et al., 2009). make up only a marginal percentage of the national population (studyingstyle.com, n.d.). Establishing tactile learning without a multi-modal approach might only satisfy a small portion of the learning classroom based on this research data. Secondly, some learners, like this student with dual learning styles, might benefit from a multi-modal approach that blends visual with read/write aspects. This would likely be a better training method when the learning takes place in a group with a high population of learners trying to comprehend the same training concepts, such as a business organization. Many individuals maintain multi-modal learning talents and this should be recognized to ensure that a program maintains elements for multi-modal learners. This might require the trainer to have a competent background in dual learning approaches, or conducting pre-testing in the large classroom, to

Pre-1924 U.S. Economic History Term Paper Example | Topics and Well Written Essays - 1500 words

Pre-1924 U.S. Economic History - Term Paper Example In 1800, a quarter of the American population was in the labor force. Between 1800 and 1900, the labor force increased at an annual rate of approximately 3 percent. This growth was unprecedented although the civil war slowed it down. The arrival of immigrants in America affected the growth of the nineteenth century labor force. Majority of the immigrants came from East and South Europe. The composition of the work force included more males than females. However, males below the age of fifteen did not work since they needed to attend schools at the time. Those above the age of fifteen were however the largest percentage in the labor force. Females also accounted for a proportion of the labor force although they were not as many. However, their rate of participation kept increasing throughout the century. Majority of these women were single and young, since most of the married ones stayed at home. Slaves also accounted for the overall amount of those in the labor force. At the close of the civil war, slavery was abolished and this is among the reasons why there was a decrease in the overall labor force. Since majority of black women and children had forcefully worked as slaves, when slavery was declared illegal, they ceased to work. The proportion of men however remained the same as most of them continued to work to sustain their families. It was during this time that craft workers in the workshops were replaced by the large industrial working class people. At the end of the 19th century and the start of the Second World War, the labor market entered in a phase of labor homogenization. This meant that the market was divided as either primary or secondary labor market. The primary labor market was disproportionately composed of highly skilled or the well-educated white male. In this category, the employment was secure, the earnings were high, and the edging benefits were generous. The secondary labor market was disproportionately composed of a large number of wome n, racial minorities, Africans, and Hispanics. These people were unskilled and lacked education. They worked in small enterprises that had low investments, employment was insecure, the earnings were low, and edging benefits were insufficient. In the 19th century, most of the American businesses were categorized as a monopoly. As other businesses continued to emerge, others such as the petroleum, sugar, and tobacco industries took control of the labor market. Due to the monopoly, many firms faced competition from their competitors, and this resulted to lowing of prices and passing of the saving along to the consumer in order to increase sales and make profits. During this period, there was pressure from the competitors, and there was a threat of reduced profits that motivated the US companies to reduce prices and maintain high levels of production. During this era, there was a lot of wasted land that needed to be exploited, yet wealth per capita was increasing at a high rate in Europ e, and all available land was used. The neo-classists explained that there was equilibrium growth in terms of accumulated capital. This had put a lot of emphasis on savings as the main source of growth. Walrasian stated that, the net saving by the wealth-holders was shammed to be exactly balanced by net investment in additional production capacity. During the 19th century, industrial revolutions occurred; these included the invention of long distance transport, the steam engine, and the

Quality Improvement Project for Patient Prescription Record

Quality Improvement Project for Patient Prescription Record The aim of this quality improvement project is to ensure that nurses record in the designated box on patients Prescription and administration record (to be referred to as: Kardex) if High Dose Antipsychotics Monitoring is Applicable YES or NO (to be referred as: applicable Y/N) and subsequently if yes, that the High Dose Antipsychotic Therapy monitoring form (to be referred to as: Monitoring form and the Early Warning Signs (EWS) Form have been activated for completion. The purpose of this is to secure patient safety from the side effects of the medication. There is widespread evidence which clearly links antipsychotic medication contributing to physical health problems such as cardiovascular problems, weight gain, endocrine problems, metabolic syndrome and sudden death (Gumber et al, 2010; Churchword et al, 2009; Tyson et al, 1999). Many premature deaths of people with serious mental illness are due to poor medical care that fails to monitor risk factors which may be due to side effects of medication (Cohen Hove, 2001). A council report by the Royal College of Psychiatrists (2006) revealed that past audits of high dose antipsychotic prescribing for in- patients showed poor adherence to monitoring recommendations. All patients on high dose antipsychotic treatment must be monitored. These guidelines attempt to clarify the identification of patients on high dose antipsychotics, factors to be taken into account before such prescribing and the documentation required when antipsychotics are prescribed in high dose; furthermore it is a polic y requirement of Forth Valley that this documentation is completed for these patients (Forth Valley, 2011). The charge nurse highlighted a concern when evaluating the patients Kardex audit, it showed 100% non-compliance for the completion of the Yes/No response for high dose antipsychotics monitoring. Subsequently when the patients are receiving high dose antipsychotics, there was inconsistency of the completion of the Therapy monitoring form and EWS form. A recent audit of patient Kardexes confirmed the charges nurse finding (see Pareto chart, Appendix B). To begin the process of the quality improvement project, a general ward meeting was held and attended by all staff in the ward that was on shift. During the meeting the charge nurse highlighted the recent findings of the Kardex audit. Concerns were raised that many areas on the Kardex were not being completed, and reminded staff nurses that this is not acceptable and needs to be improved. As a nurse it is extremely important to keep accurate documentation, good record keeping is an fundamental part of nursing practice, and is necessary to the delivery of safe and effective care (Nursing and Midwifery Council, (NMC) 2010). As an attempt to focus the quality improvement project more specifically the results of the audit were presented using a Pareto chart (Appendix B). The data confirmed the areas on the Kardex which were not being completed however, high dose antipsychotic monitoring Yes/No was the highest at 100% non-completion, therefore it was agreed that a new strategy would be implemented to improve this. McLaughlin and Kaluzny (2006) state that the defect focused on does not necessarily need to be the greatest frequency to be improved first, but attention should be given to that defect that may have a devastating result, such as an adverse event or even death. However the defect in this instance was the highest and potentially could cause an adverse event. Following the meeting a questionnaire (Appendix C) was devised and completed anonymously by the pharmacists, consultants and staff nurses to identify the root causes of why this area on the Kardex was not completed. A fishbone diagram was used to illustrate the findings (Appendix D). When populating the fishbone diagram with the data, it was clear to see that there were many reasons that each member of the multidisciplinary team had not completed the applicable area on the Kardex. Role confusion was a common theme from each member of the team. Hill-Smith et al (2012) claims that this is not unusual within multi-disciplinary teams and that respectful communication and clear instructions is of high importance in the delivery of high quality clinical care. Therefore based on these findings PDSA one was developed (Appendix G1). This tested whether the nurse attending the MDT meeting completes the Applicable Y/N on the patients’ Kardex following an email reminder and a verbal promp t from charge nurse before attending the meeting. The test confirmed there was a breakdown in communication, the nurse did not receive the email or a verbal reminder from the charge nurse prior to attending the MDT meeting therefore they were not aware of the procedure that had been discussed and as a consequence the applicable area on the form was not completed, this was confirmed by an audit of the Kardex (Appendix H). This informed the decision for PDSA two (Appendix G2). The nurse coordinating the shift should use the visual prompt situated on the shift coordinating sheet to remind the nurse attending the MDT meeting, to update applicable Y/N on the patients Kardex. The small change of a visual reminder on the shift coordinating sheet proved to be success. It reminded the coordinating nurse to verbally prompt the nurse attending the MDT meeting to complete the patient’s Kardex in the applicable area, which was shown by the Kardex audit after the shift; all patientsâ€℠¢ Kardexes were completed and as a consequently the Therapy form and EWS from were also initiated for completion. These findings are consistent with Simpson (2007) research, where teams have clear operating procedures in place, care coordinating is enhanced. The assumption was that the email and verbally prompt from the charge nurse would result in nurses completing the Applicable Y/N on all patients Kardexes, following the MDT meeting by 23rd February 2014 by 100%. Furthermore, if yes the Therapy form and the EWS form activated for completion. Audits were carried out on the dates shown to give a snapshot of the completion of Applicable Y/N on all patients Kardexes in the IPCU ward at that time. Initial findings of the first audit by the charge nurse on 01/02/2014 revealed that Applicable Y/N was completed 0%. The second audit carried out to confirm the previous results on 08/02/2014 which confirmed the charge nurses findings of 0% compliance of Applicable Y/N. PDSA one was carried out on 10/2/2014 the change revealed 0% improvement in the completion of Applicable Y/N. PDSA two was implemented on 21/2/2014 the change was successful, the results of the audit revealed that Applicable Y/N was completed on all patients Kardexes by 100% this in turn activated the completion of the Therapy form and EWS Form. Comparison of questions, predictions, and analysis of data: Engaging with the quality improvement (QI) project has required me to learn and apply new skills in practice. The process of plan, do, study, act (PDSA) cycles were a new technical skill which I had to not only learn myself, but teach fellow staff nurses on the ward, as this was also, a new process to them. I learnt that PDSA cycles provisionally test an idea by testing a change and assessing its impact. After implementing the first cycle, I learnt that it does not always get the results expected when making changes to your process; it taught me that it was better, and more effective to trial a small change to see if it made a difference, before implementing the change permanently. This also gave staff the opportunity to be involved and offer suggestions and see if the proposed changes would work. I also learnt that communication is an essential and fundamental process during the course of the QI. According to Adams (1999), to persuade others to make an improvement or change, the negotiator must be influential. The Charge nurse in this instance was the influential position to lead change. Unfortunately they were not able to fulfil their obligation in PDSA one, but they carried out the ward meeting and used this as a platform to discuss the Kardex audits with the staff which informed them of the need to make an improvement in practice. Once the need for the new process was established and its principles by the email from the charge nurse, informing the reasoning for a change in practice, this was used as a base for PDSA two. I learnt that it is just as important to define the risk of not making a change (Plummer, 2000) and in this circumstance, changing practice would not only enhance quality of care to patients, but it would promote the involvement between staff nurses and the MDT, building trust and confidence to make the change, whereas the risk of not making the change, could potentially cause an adverse event A final learning point I would like to include was how staff nurses initially were resistant to change. In my opinion from observing, the nurses were quite defensive as though they were being blamed for not doing their job correctly. The questionnaire used was an effective communication tool and successful resource for managing this resistance. It give staff the opportunity to anonymously feedback their reasons for not completing the applicable area on the Kardex, it also let them express their opinion without being condemned. Also, I feel that during this time, they were able to adjust and prepare for the change which minimised resistance (Bernhard and Walsh, 1995). I felt it was essential to take note of all their views as individuals and as team members, which provided further explanation of their reasoning for non-completion. Accountability was a consistent reason used by nurses for their reason for non-completion, as they felt it was a doctor or the pharmacist role and they did not want to be accountable for making the decision. When it was clarified that it was a team decision, by email from the charge nurse, the nursing staff felt supported. Mitchell (2001) states that accountability in nursing is a complex issue and acknowledged the importance of team support in the identification of roles and responsibilities. Frequent ideas and conversations with staff were held over the ten days, in advance of the change in PDSA two which I feel made the improvement successful and run smoother as nursing staff were aware of the new change. I have learnt that within nursing it is important to continually improve the way we work. Working at every level developing the knowledge, technical skills, including leadership, are vital for long-term improvement. Continually learning may be important not only to ensure that we have the skills needed to improve the quality of healthcare, but also to enhance the motivation to do so. Discuss the project’s significance on the local system and any findings that may be generalizable to other systems: Relocation to a new site change what been good practice and now a gap had appeared in the process of monitoring patient. The outcome of this project was a success. It was predicted that by 23rd February 2014 applicable Y/N would be completed by 100%. By establishing the success of the visual prompt in PDSA two on the co-ordinating sheet, was a very small but effective change. As a consequence, at the following staff meeting it was decided that the visual prompt would be a permanent fixture on the coordinating sheet, as it was a sustainable reminder to future shift coordinators, thus improving the initiation of therapy monitoring and EWS forms, and overall patient safety outcomes. Discuss the factors that promoted the success of the project and that were barriers to success. What did you learn from doing this project? What are your reflections on the role of the team? The factors which promoted success in the project were support and leadership from the charge nurse at the beginning of my placement. They helped identify areas in the ward which they felt needed improvement. Furthermore, as a student who had never been in a mental health ward, I felt overwhelmed with the task and this support and guidance helped me through the project. The use of the tools were a great way to involve staff on the ward to feel part of the project and broke down the barriers of pointing blame and focussed their attention in a systematic way, and explored the potential causes of the non-completions. I was amazed as how such a small change help facilitate and test change in a manageable way. I now understand that Quality improvement as a way of approaching change in healthcare that focuses on self-reflection, assessing needs and gaps, and considering how to improve in a multifaceted manner. I feel I have gained an enormous understanding in about quality improvement in that it aims to create an ethos of continuous reflection and a commitment to ongoing improvement. It provides nurses to gain an the skills and knowledge needed to assess the performance of healthcare and individual and population needs, to understand the gaps between current activities and best practice and to have the tools and confidence to develop activities to reduce these gaps Thus, the scan did not focus only on narrowly defined quality improvement models such as ‘plan, do, study, act’ (PDSA) cycles.

Arrival of Things from Another Culture in Hurricane hits England and Presents from my Aunts in Pakistan :: essays research papers

In ‘hurricane hits England’ (hurricane) by Grace Nichols the arrival of the hurricane challenges the thoughts of the poet, she is initially from the Caribbean but now live in Sussex, until the arrival of the hurricane she has not felt at home in England. This is similar to ‘presents from my Aunts in Pakistan’ (presents) by Moniza Alvi, she also has roots from another country and now lives in England. The arrival of presents from the Pakistan culture challenges her thinking, as does the hurricane to Nichols. The hurricane challenges her thinking by making her realise that it is possible to bring your roots anywhere. She comes to this realisation through the poem and at the end of it comes to the conclusion that ‘the earth is the earth is the earth’. She originally feels torn between her two cultures, it takes the arrival of the hurricane ‘to bring her closer’. Whereas in ‘presents’ it is the arrival of the presents from Pakistan that make her feel torn between cultures. The clothes are a symbol of culture, she feels ‘alien’ and awkward wearing them and much more comfortable in her English ‘denim and corduroy’. Nichols also uses symbolism in her poem, the hurricane is a symbol of her Caribbean culture. They are very irregular in England but a regular occurrence in her childhood in the Caribbean, this makes her feel comfortable and at home. The hurricane is used along with many other natural images, this is mainly because of the effect of the wind on the landscape, for example the 'trees / Falling heavy as whales' is an effective line because the huge trees become like whales when the torrential rain that accompanies a hurricane makes the land become almost like a sea. Another natural image is the ‘frozen lake in me’ which metaphorically is the poet being ‘frozen’ away from her county and now the hurricane has arrived to break the ice, so she can bring her roots anywhere. ‘Presents’ also uses natural images, the poet describes the sari that is sent as ‘apple-green’ and the salwar kameez as ‘peacock blue’ and the other ‘like an orange split open’. This vibrant simile and the repeated reference to colour draws her to the loveliness of the culture and emphasises the contrast to the boring English

Did William Pitt Bring About a National Revival?

Did William Pitt Bring About A National Revival? On one hand, it is easy to believe that Pitt did bring about national revival but on the other hand there are many factors that may lead one to believe otherwise. For example, the end of the American war and the Industrial Revolution both would have happened whether Pitt was in power or not. But many factors, such as Pitt’s natural skill and his reform ideas, helped him to contribute to the national revival. Pitt introduced the Eden Treaty and formed it with France.This helped to increased trade in Britain as, as a country, exports were vastly increased. Pitt also tightened the laws around smuggling items both into and out of Britain which also increased trade. He did this by introducing bonded warehouses, where goods could be stores free of tax until they were taken out of Britain for sale. The Sinking Fund was also introduced by Pitt and helped, again, to increase the amount of money in Britain. He did this by using Britainâ⠂¬â„¢s profits to pay off debts instead of spending money on other goods, but this was interrupted by the war against France.Pitt also made sure that all of the government’s money was collected and spent correctly in the right places. The streamlining of the Treasury’s financial management with the Consolidation Fund Act, where all 103 exchequer accounts were replaced by one, allowed proper national accounting. However, there were many factors that contributed to a national revival that Pitt was not responsible for. Pitt inherited the national deficit which was a huge advantage to him because it meant that the state of Britain and the government could only improve.The end of the war in America meant that overseas trade would increase and this helped Britain’s imports and exports to boom. This was also helped along by the Industrial Revolution, beginning in the North East, which increased trade in and out of Britain. To conclude, in many ways Pitt did contribute greatly to the national revival but he was helped by other factors that were out of his reach. The Sinking Fund helped Pitt along greatly but he was also assisted by the Industrial Revolution and booming trade from other nations.

The Pros and Cons of Parole - 2509 Words

Parole is a highly controversial issue in Australia and around the world. A likely cause for this controversy is the general publicÂ’s ignorance of the specifics where parole is concerned. Any casual observation of a local newspaper or current affairs program on TV will likely result in the discovery of a member of the publicÂ’s opinion of crime and criminals and the criminal justice system in general, and what they believe to be wrong with it and no doubt suggestions on how to fix it. These opinions will probably be biased in nature, and influenced by information supplied to them by various forms of media. This information does not necessarily reflect the reality of the situation regarding the parole system. Adding to this potential for†¦show more content†¦It was designed as a concession to the prisoner which was also expected to benefit the community as a whole, at the same time providing the environmental influences which would discourage the offender from committi ng further offences (Law Reform Commission NSW, 2001). Parole was originally designed in the mid-1800s as an alternative to incarceration when it became apparent that incarceration was unsatisfactorily effective at preventing further criminal behaviour by offenders (Travis, 1995). It was agreed that a system of reform would prove more effective than imprisonment when it came to producing law-abiding citizens. While parole has its origins in America, it underwent revision on Norfolk Island in a British penal colony operated by Alexander Maconochie, now referred to as the “father of parole”. This system, where prisoners were allowed increasing levels of freedom and other benefits in reward for good behaviour and productivity, laid the groundwork for the modern parole system in use today, though there have been modifications made in response to changing political and economic situations, as well as legal challenges. The parole system has had its criticisms in the years since its introduction into the Australian criminal justice system, with some questioning the procedures involved, and others calling for the abolition of parole altogether. Some of these criticisms come in the form of somewhat one-sided, subjectiveShow MoreRelatedPros and Cons of Parole Programs572 Words   |  2 Pagesoff, parole is â€Å"the conditional release of a prisoner, prior to completition of the imposed sentence, under the supervision of a parole officer† (Schmalleger Smykla, 2013). Parole is a constrained relief that requires parolees to tolerate rules that do not apply to other members of society (Corbett, 2014) .Parole has been used for early release from prison for more over a century, but never before have so many individuals been released from prison (Schmalleger Smykla, 2013).Parole is usuallyRead MorePros And Cons Of The Exclusionary Rule1017 Words   |  5 Pagesabout the pros and cons of the exclusionary rule, how it is effecting the criminal justice system of the United State. In addition, I will speak and summarize the case of Pennsylvania Board of Probation and Parole v. Scott from 1998, this will be a great example of the exclusionary rule and the effects about them. Furthermore, I will show how this case was important with the Exclusionary Rule, and my opinion on the matter. Arguments are powerful in the United State on the pros and cons of the exclusionaryRead MoreJob Functions Of Being A Parole Officer1218 Words   |  5 PagesSSgt. Monica Pickles of the Jasper County Parole Office located in Ridgeland, South Carolina. I chose to do this interview of Mrs. Pickles because she has a very unique approach with her parolees that you wouldn’t normally see with some Parole officers. Plus she seemed like a kind hearted person who wouldn’t mind taking some time out of her busy schedule to help a student out. She has truly made it a lot easier to understand what it takes to be a Parole Officer and the challenges that come with itRead MoreThe Death Penalty Is Too Than Life Without Parole1274 Words   |  6 Pages there is a better alternative which is life without parole. The death penalty is unnecessary because the high cost of the death penalty, puts innocent lives at risk, capital punishment doesn’t deter crime, the death penalty is crue l and unusual punishment, and Deterrence value of the death penalty. The high cost of the death penalty is the first thing that will be talked about. the death penalty is much more expensive than life without parole because the Constitution requires a long and complexRead MoreCapital Punishment : A Form Of Discipline Essay1729 Words   |  7 PagesThe â€Å"North Carolina Coalition for Alternatives to the Death Penalty† states that the use of executions hasn’t been used since 2006 and in 2012 for the first time no one received the death penalty. When it comes to the death penalty you have pros and cons. A pro would be that the death penalty is the most extreme punishment a criminal should receive for the horrific crime they have committed. The punishment should be based off the crime committed and if the crime was extreme than extreme measures shouldRead MorePros And Cons Of The Death Penalty789 Words   |  4 Pagesand sit on death row anywhere from five to ten years before being executed. Pros of this is the cost of life in prison is much less than execution. However a con of life in prison is that it could potentially be more expensive because they use statistics for someone who spends fifty years in prison. Another pro of life in prison is that it would fill up the prisons and give more federal aid to the prisons and states. A pro of the death penalty is if the prison system is overcrowded, the person hasRead MoreCapital Punishment and Life Without Parole Essay897 Words   |  4 PagesDen Haag in â€Å"for the death p enalty† â€Å"therefore nothing will deter a criminal more than the fear of death†¦ life in prison is less feared (Haag). Furthermore capital punishment is more cost effective than LWOP (life without parole). When a person is sentenced to life without parole they are kept in a prison and it takes money to keep prisons going. The more people in a prison the more money it takes for that prison to run. In 1995 it cost $49 billion dollars to run all of the prisons in all 50 statesRead MoreCriminal Justice Outline1660 Words   |  7 PagesCapstone Project One Nov. 22, 2011 Trial a. Interrogation and Arraignment- Guidelines and Process of Law b. Trial- Judge and Supreme court roles c. Sentencing – 3 types Sentencing a. Determinate- pros and cons b. Indeterminate- pros and cons c. Mandatory- pros and cons d. Specific or general deterrence Determinate sentencing a. Time- Each punishment is set person to person regardless b. Punishment- does not discriminate c. Community- deter people from committing itRead MoreShould the Death Penalty Be Abolished?2750 Words   |  11 Pagesdeath penalty is a major debate that Americans have faced for many years. Who are we though to commit a crime against one who committed the wrongful crime? Doesn’t this make us just as guilty as the criminal? Through this paper we will explore the pros, cons, and whether the death penalty serves to morally normalize society. The death penalty is a major debate in the United States that many feel is wrong, and has been for many years. There are thirty-five states in the United States that stillRead MoreThe Death Penalty Of The United States948 Words   |  4 Pagesimportance of the death penalty. Phil for Humanity points out how expensive it is to house inmates, and that these individuals are extremely dangerous to society (Phil for Humanity). This paper will discuss the pros and the cons of the death penalty in greater detail. There are many pros and cons to the death penalty. Some find it hard to believe that the United States would command a person executed for killing another human being. According to the article The Impact of Information on Death Penalty