...Running Head: Nurse Sensitive Indicators WESTERN GOVERNORS UNIVERSITY RTT 1 TASK 1 ANNE ANDERSON Running Head: Nurse Sensitive Indicators: 1 Nursing reflect the process, structure and outcomes of nursing care. Process indicators measure the aspects of nursing care such as assessment, intervention and nurse satisfaction. The structure of nursing care is determined by the quantity of nursing staff, the skill of the nursing staff and the education and certification of the nursing staff. Patient outcomes determined to be nursing sensitive are those that improve with better quality and greater quantity of nursing care (ANA). Understanding of these nursing indicators could have helped the nurses involved in this scenario. Knowing the pressure ulcer prevalence may have helped prevent one in this case. The nurse and CNA would have known to reposition the patient to prevent pressure ulcers and would have recognized a red area as a stage one pressure ulcer. The CNA would not have place the patient back to bed on his back and CNA would have reported the reddened area to the nurse. Restraint prevalence would have assisted with the nurse’s and CNA’s understanding of how to apply and manage a patient in restraints. Patient satisfaction is a nursing indicator that was not taken into account in this scenario. The nurse would have talked to the...
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...Running head: NURSING SENSITIVE INDICATORS 1 Nursing Sensitive Indicators Organizational Systems and Quality Leadership RTT 1 Task 1 August 29, 2014 NURSING SENSITIVE INDICATORS Nursing Sensitive Indicators To analyze the given scenario one must first have a foundational understanding of what nursing sensitive indicators are and how they could have been used to significantly improve patient care. Next the analysis will determine how the hospital will use these indicators to improve overall patient care. The analysis will conclude by identifying specific resources that could be used to resolve the ethical issue in this scenario. It wasn’t until 1996 that the term Nursing Sensitive Indicators was used. Nursing sensitive indicators are by definition,” elements of patient care that are directly affected by 2 nursing practice.”(American Sentinel University - Healthcare, 2011, para. 1) These elements can be further broken down into: Structure - This includes staffing levels, staffing mix, staff education level and the staff experience level. Processes – This includes methods of assessment, methods of care, and types of interventions. Outcomes – these are directly related to quality and quantity of nursing care. With the given scenario, many nursing specific indicators could have been observed to significantly improve Mr. J’s hospital experience. Restraint prevalence is the first issue that could be addressed. If the nurse was more aware of this he or she would...
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...RTT Task 1 Robert Sekulic Western Governors University Quality of care for hospital patients during their hospital stay plays an integral role in the healing process for patients. Every patient deserves the right to receive care when care is needed and the right to receive appropriate and safe interventions associated with that care. It is the responsibility of all members of the healthcare team to provide the best quality of care to patients and to advocate for the patients on matters both right and wrong. In the scenario involving Mr. J, many members of the healthcare team failed to advocate for the patient and failed to provide the best quality of care the patient deserves. Nursing sensitive indicators could have played a key role in providing Mr. J an appropriate hospital stay and getting the appropriate interventions to provide the best possible outcomes for the patient. Knowledge pertaining to the appropriate use of restraints and appropriate interventions associated with the prevention of pressure ulcer formation would have provided the staff with the ability to provide proper care to the patient. By unnecessarily restraining the patient and failing to provide appropriate interventions associated with repositioning of the patient, the staff increased the chances for the development of pressure ulcers by Mr. J. The restraint of the patient increased the chances of the patient developing post surgical complications such as deep vein thrombosis and pressure...
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...In analyzing Mr. J’s situation it is important to consider nursing-sensitive indicators and how this is an indicator of quality patient care. It is also important to note how this creates an ethical issue and to learn from the situation companywide. Many situations like Mr. J’s happen every day and are swept under the rug. Patient care should always involve patient needs along with cultural considerations while maintaining consistency with evidence based medicine practices. Nursing sensitive indicators assist to identify potential issues related to quality that may come about during patient care. Identifying nursing sensitive indicators allows nurses to improve the quality of patient care which results in increased patient satisfaction and improved patient outcomes. The American Nurses Association (ANA) is a great resource and wealth of information to assist in identifying specific indicators to apply to patient care. Nursing sensitive indicators bring light to specific patient needs. In the case of Mr. J several nursing sensitive indicators can be identified; his recent fall resulting in a hip fracture, he has dementia, cultural and religious values, immobility, pressure ulcer risk, the use of restraints, and pain management techniques. The diagnosis of dementia identifies that Mr. J is unable or has limited ability to reason with sound judgment along with the added use of pain medications. All of these indicators can lead to quality patient care if nursing applies them...
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...RTT 1 Task 1 Mr. J, 72-year-old, retired rabbi Mild dementia, Fx right hip s/p fall Receiving pain medication, drowsy Restrained in bed, even when slightly sleepy. Restraints reapplied with family present. Dtr notices red, depressed area over lower spine (CNA blew it off, “it will go away”) Diet: Regular, Kosher, chopped meat Given pork chop (nurse notified supervisor, supervisor notified kitchen supervisor, kitchen supervisor notified kitchen staff) Kitchen staff apologized to dtr. Dtr asked nurse, who blew itoff. Nursing Sensitive Indicators….Discuss how an understanding of nursing-sensitive indicators could assist the nurses in this case in identifying issues that may interfere with patient care. (pressure ulcers, patient satisfaction, “paucity of scientific evidence linking nursing with hospital patient outcomes”, nursing-sensitive performance measures are processes and outcomes – and structural proxies for these processes and outcomes {skill mix, nurse staffing hours} that are affected, provided, and/or influenced by nursing personnel, but for which nursing is not exclusively responsible. Patient-Centered Outcome Measures: Failure to rescue, Pressure ulcer prevalence, Falls prevalence, Falls with injury, Restraint prevalence (vest and limb only), Urinary catheter-assoc UTI rate. System-Centered Measures: Skill mix Mix of nurses and unlicensed staff caring for patients in the acute-care setting • Total nursing-care hours provided per patient day • Nosocomial...
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...means that some algorithms control congestion issue by adjusting the traffic load, while others adopt approaches in which finding the least congested route would be their ultimate goal. The methods for congestion control in are presented in two groups. 1. end-to-end 2. Hop-to-hop 1. end-to-end: In this approach the congestion control is performed by the receiver by controlling the transmission of interest packets. The two protocols which are to be considered here are the interest control protocol (ICP) and Information Centric Transport Protocol (ICTP). In these protocols, the congestion window is placed in the receiver side to control the number of transmitted interest packets. The congestion window specifies the maximum number of interest packets that can be exited from the receiver. In ICTP and TCP the same algorithm is used in the receiver side in order to transmit the interest packets which has the least adaptation with the NDN infrastructure. In both of these protocols, only a single RTT estimator is used in the receiver to know the network status. Because of having multiple path for each flow in NDN, a single RTT is not appropriate. Separate RTT is calculated for each route in any of the receivers. Although multiple RTT is appropriate for NDN, there is much complexity to the receivers. 2. Hop-by-hop: Transmitting single data packet in response to each interest leads to flow balance in NDN. This one-to-one flow balance can be used to control the congestion more effectively...
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...Michelle del Rosario Effective Leadership & Management Class - Barbara Miller Individual Paper March 14, 2013 The Application of the SCARF Model on the 2011 Re-Organization of SF Court Reporters I. INTRODUCTION On Friday, September 30, 2011, the San Francisco Superior Court (SFSC) laid-off a total of sixty-seven (67) employees, including twenty-nine (29) Certified Court Reporters. The Court started the fiscal year of 2011-2012 with a $13.75 million budget deficit, and had initially mailed out two hundred (200) pink slips in July, representing 41% of it’s staff. Fortunately, austerity measures (such as extending mandatory furlough days, enforcing voluntary unpaid time off, reducing office hours, and closing civil courtrooms) and very aggressive negotiations with the Administrative Office of the Courts (AOC) resulted in an additional $7.5 million that was used to salvage one hundred thirty-three (133) careers. September 30, 2011 was a devastating day to these sixty-seven (67) employees, and this paper will focus particularly on the effects of this re-organization on the emotions and reactions of the Court Reporters who were directly and indirectly affected. The SFSC website defines Court Reporters as “guardians of the record”. It is emphasized that not only are they Court employees, but they are also purveyors of transcripts for all interested parties. Their main job duties are providing legislated transcripts of criminal proceedings, and...
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...between two countries, the next step is to extend the cable and satellite links to centers of population and commerce. These extensions are often referred to as international access links, and are usually concentrated at a small number of locations, depending upon the traffic. vi. Internet: The Internet carries various information resources and services, such as electronic mail, online chat, file transfer and file sharing. Question2: a) ↑ [pic] Note: all the classes that is written in blue are separated classes b) Channel capacity= bit rate*RTT = (1*10ˆ7)*(1.5*10ˆ-3)=15*10ˆ3 bits. A message of 1500 octets transports 8*1500=12*10ˆ3 bits. Percentage utilization of channel is 1500 times the ratio between the number of bits sent...
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...IJCST Vol. 3, Issue 4, Oct - Dec 2012 ISSN : 0976-8491 (Online) | ISSN : 2229-4333 (Print) End-to-End Congestion Control for TCP 1 1 K. Pavan Kumar, 2Y. Padma Dept. of CSE, Usha Rama College of Engineering and Technology, Telaprolu, AP, India 2 Dept. of IT, PVP Siddhartha Institute of Technology, Kanuru, Vijayawada, AP, India Abstract Reliable transport protocols such as TCP are tuned to perform well in traditional networks where packet losses occur mostly because of congestion. However, networks with wireless and other lossy links also suffer from significant losses due to bit errors and handoffs. TCP responds to all losses by invoking congestion control and avoidance algorithms, resulting in degraded end-to-end performance in wireless and lossy systems. The proposed solutions focus on a variety of problems, starting with the basic problem of eliminating the phenomenon of congestion collapse, and also include the problems of effectively using the available network resources in different types of environments (wired, wireless, high-speed, long-delay, etc.). In a shared, highly distributed, and heterogeneous environment such as the Internet, effective network use depends not only on how well a single TCP based application can utilize the network capacity, but also on how well it cooperates with other applications transmitting data through the same network. Our survey shows that over the last 20 years many host-to-host techniques have been developed...
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...Microsoft Corporation Nmap® is a registered trademark of Insecure.Com LLC Red Hat® is a registered trademark of Red Hat, Inc. Ubuntu® is a registered trademark of Canonical Ltd. UNIX® is a registered trademark of The Open Group All other trademarks used in this book are property of their respective owners. Use of any trademark in this book does not constitute an affiliation with or endorsement from the trademark holder. All information in this book is presented on an “as-is” basis. No warranty or guarantee is provided and the author and/or publisher shall not be held liable for any loss or damage. 3 4 Contents at a Glance Introduction....................................................................................... 15 Section 1: Installing Nmap .................................................................. 19 Section 2: Basic Scanning Techniques .................................................. 33 Section 3: Discovery Options .............................................................. 45 Section 4: Advanced Scanning Options................................................ 65 Section 5: Port Scanning Options...
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...The Rabbi Helen Frace Western Governors University RTT Task 1 The Rabbi Mr. J is an elderly, retired, Jewish rabbi of 78 years old. Due to a hip fracture Mr. J was admitted to the hospital. Issues were identified during Mr. J’s hospital stay, which could have been improved to make Mr. J’s stay more pleasant. In 1994 the American Nurses Association (ANA) started the Patient Safety and Quality Initiative. It was a pilot program designed to evaluate the links between nurse staffing and quality care (Montalvo, 2007). The program outcome was a set of nursing-sensitive indicators used to evaluate quality care for patients in the acute setting and the start of the National Database of Nursing Quality Indicators (NDNQI). The NDNQI is a database which collects the information from the survey collected from the acute care settings. The information compiled is used to develop nursing care and influence the quality of care given to patients (Montalvo, 2007). “Nursing-sensitive indicators identify structures of care and care processes, both of which in turn influence care outcomes” (Montalvo, 2007, para. 3). Knowing the nursing-sensitive indicators could have helped Mr. J in multiple ways. Pressure ulcer prevalence is one of the indicators that could have helped the situation. If the CNA who was helping Mr. J to the restroom had more training and knowledge about pressure sores they would have been able to identify that Mr. J had some skin breakdown. The skin breakdown happens when...
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...originalarbeiten Elektrotechnik & Informationstechnik (2006) 123/7/8: 288–296. DOI 10.1007/s00502-006-0362-y Traffic monitoring and analysis in 3G networks: lessons learned from the METAWIN project F. Ricciato, P. Svoboda, J. Motz, W. Fleischer, M. Sedlak, M. Karner, R. Pilz, P. Romirer-Maierhofer, E. Hasenleithner, W. Jager, P. Kruger, F. Vacirca, M. Rupp ¨ ¨ A 3G network is a magnificently complex object embedded in a highly heterogeneous and ever-changing usage environment. It combines the functional complexity of the wireless cellular paradigm with the protocol dynamics of TCP=IP networks. Understanding such an environment is more urgent and at the same time more difficult than for legacy 2G networks. Continuous traffic monitoring by means of an advanced system, coupled with routine expert-driven traffic analysis, provides an in-depth understanding of the status and performances of the network as well as of the statistical behaviour of the user population. Such knowledge allows for a better engineering and operation practice of the whole network, and specifically the early detection of hidden risks and emerging troubles. Furthermore, the exploitation of certain TCP=IP dynamic behaviour, particularly the TCP control-loop, coupled with information extracted from the 3GPP layers, provides a cost-effective means to monitor the status of the whole network without requiring access to all network elements. In this article the main lessons are summarized learned from a two-year...
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...RTT/P.M.I TEAM (M203 Grenade Launcher) 071-2098 / Version 3 11 January 2010 SECTION I. ADMINISTRATIVE DATA All Courses Including This Lesson| Course Number Version Course Title 750-BT B Basic Combat Training| Task(s)Taught(*) or Supported|Task Number Task Title Individual 071-311-2125 (*) Maintain an M203 Grenade Launcher 071-311-2126 (*) Perform a Function Check on an M203 Grenade Launcher 071-311-2127 (*) Load an M203 Grenade Launcher 071-311-2128 (*) Unload an M203 Grenade Launcher 071-311-2129 (*) Correct Malfunctions of an M203 Grenade Launcher071-311-2130 (*) Engage Targets with an M203 Grenade Launcher| Reinforced Task(s)| Task Number Task Title| Academic Hours|The academic hours required to teach this lesson are as follows: Resident Hours/Methods 10 mins / Conference / Discussion 2 hrs 40 mins / Practical Exercise (Performance) Test 0 hrs Test Review 0 hrs Total Hours: 3 hrs | Test Lesson Number| Hours Lesson No. Testing (to include test review) N/A | Prerequisite Lesson(s)| Lesson Number Lesson TitleNone| Clearance Access|Security Level: UnclassifiedRequirements: There are no clearance or access requirements for the lesson.| Foreign Disclosure Restrictions|FD6. This product/publication has been reviewed by the product developers in coordination with the (installation/activity name) foreign disclosure authority. This...
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...Tesco’s Recent Leadership and Change Management Name Course Date Tesco’s Recent Leadership and Change Management Introduction Tesco is one of the food and drink outlet industries in United Kingdom. It is a source of employment for over four million people, especially at primary production, assembling and selling to consumers (Alzola 2008). In UK supermarkets such as Tesco, they are under strict control by the government due to suppliers’ treatment concern. However, strategic supply improvements remain the main concern for most supermarkets for the past years (Auboin 2007). Analysis of Challenges in Tesco Company SWOT analysis of Tesco challenges provides the intended knowledge on: • Strengths of the company • Weaknesses of the company • Opportunities available for expansion in other nations • Threats and challenges likely to be encountered as a result of current and future market competition at global and regional levels. There are a number of strengths that Tesco can base its stamina in the growing market. However, Tesco’s market strength can largely be improved through increasing the market shares. This policy is an excellent strength that determines its stability in the competitive market (Stephen 2011). There are several weaknesses that challenge the development of Tesco as outlined in SWOT analysis. For example, reliance upon the UK market affects the market...
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...RTT Task 1 WGU Nursing –Sensitive Indicators In the case of Mr. J, a 72-year-old retired rabbi with a diagnosis of mild dementia, the nursing sensitive indicators include restraint use, hospital acquired pressure ulcers, and patient-family satisfaction with nursing and overall care. Not understanding and identifying nursing-sensitive indicators contributed to adverse outcomes, which included the development of a pressure ulcer and the likely unnecessary use of restraints. Lastly, family dissatisfaction with care was evidenced when the daughter called the patient’s physician to complain that her father had not received the ordered kosher meals. If the hospital nursing staff had understood and identified nursing-sensitive indicators, the negative outcomes cited above may have been avoided. The nurses would know that through data collection, measurement, and evaluation of nursing practice it has been recognized that nursing care has a direct impact on specific patient outcomes. Because of this research, the profession has been able to elevate the quality of nursing care by developing and implementing evidence based practice, which has been demonstrated to improve patient outcomes (American Sentinel University, 2014). Quality Patient Care Collecting hospital data from each unit on specific nursing-sensitive indicators could advance quality patient care throughout the hospital. Staffing levels and the mix of nursing personnel (RN, LPN’s, and CNA’s) on a unit can have a...
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