Category: Action Plan

Introduction

An action plan is a detailed strategy that outlines activities required to attain a specific objective. It is also referred to as organized steps to execute a certain task effectively. Telehealth uses electronic information and communications expertise to improve long-distance medical services, patient and professional clinical-related training, and public wellbeing management (Van Galen et al., 2019). Some of the technologies employed include the Live video streaming, mobile data applications, and social network platforms (Van Galen et al., 2019). This work details an action plan used to establish telehealth in a rural community.

A Background Check on Each Site

Since there have not been specialist services for a long time, the first thing to do will be to visit the intended site one by one to assess their suitability and readiness. The latter will enable me to write down all the resources and improvements needed for the projects success. This phase will involve informing all the workers and the community stakeholders on the new development. The latter will guarantee that all the employees are involved and feel that they are part of the program.

Central Communication Point

Telehealth is all about communication to get the right specialists to the patients in need. 24-hour running information exchanging base will need to be established. The above-mentioned procedure will ensure that nothing is missed between the patient and the specialist (McClellan et al., 2020). The point will be for setting an appointment with both the physicians and the clients. This section is important because the doctors are not based in the community and will need to see the sick and go back to their main employment areas. Matching the ailing individuals and the physicians schedules will be a vital assignment for workers here.

Resources and Necessary Equipment

The health centers will need to have treatment equipment since doctors will only come with their expertise. My colleagues and I will select the necessary machine compulsory for issues that facing our patients. This is the stage of mobilizing resources through the State government, health administration committee, or non-governmental organizations to acquire enough necessities (Pollard et al., 2017). We will also ensure that hospitals are hygienic for these exercises by ensuring that the available rooms are cleaned. In other clinics, we might also require constructing new building for this purpose since most of them are fully utilized.

The Specialists Schedules

The rural community needs various types of special treatment; people have various conditions that need different specialists. Some of the needed medics in our community include; gastroenterologists, endocrinologists, dermatologists, cardiologists, anesthesiologists, surgeons, psychiatrists, pediatricians, radiation oncology, obstetrics, gynecologists, and dermatologists, among others (Van Galen et al., 2019). It is impossible to mobilize resources for all the professionals to come to a clinic in one day, each will need a day or two in a day. A calendar will be formulated for all physicians throughout the month for better planning.

Community Mobilization

After we put every aspect of the medication to occur has been put in place, the last assignment will be to inform the community of what is available and when. Educating the residents will help maintain the schedules and ensure that the people get the services they need on time (McClellan et al., 2020). The citizens will also be required to register stating their issues, with a list of individuals in need of acre we will source for enough physicians for each category.

Conclusion

The action plan, as highlighted above, can only be successful with the right mobilization of resources and all stakeholders. We will ensure that our program works by working together as physicians, hospital administrators, and other healthcare stakeholders, including the community. Though this is a new health delivery model in our society, we have prepared ourselves for high and lows. Telehealth is an opportunity to improve services for our people.

References

McClellan, M. J., Florell, D., Palmer, J., & Kidder, C. (2020). Clinician telehealth attitudes in a rural community mental health center setting.Journal of Rural Mental Health, 44(1), 62-73. Web.

Pollard, J. S., Karimi, K. A., & Ficcaglia, M. B. (2017). Ethical considerations in the design and implementation of a telehealth service delivery model.Behavior Analysis: Research and Practice, 17(4), 298. Web.

Van Galen, L. S., Wang, C. J., Nanayakkara, P. W. B., Paranjape, K., Kramer, M. H. H., & Car, J. (2019). Telehealth requires the expansion of physicians communication competencies training.Medical teacher, 41(6), 714-715. Web.

Each person has their strengths that need to be developed, and their weaknesses, which they need to fight. I chose the profession of a nurse because it is necessary to have several strong qualities, such as discipline, independence, sociability, and self-confidence. These strengths are inherent to me, and I strive for constant development and improvement. I also have weaknesses that I will seek to correct. These include straightforwardness, excessive emotionality, self-criticism, and the desire to please everyone. This essay aims to describe the actions to develop and strengthen my strengths and eliminate my weaknesses.

A nurse needs to be disciplined, I have such a quality, and I would like not to lose it. To do this, I will allocate a certain amount of time for each task and try to accomplish it. In addition, I will make a list of necessary tasks, distribute them by priority level, and strictly follow this list. These actions will help me develop my discipline and dose the time for work and rest.

To develop my independence, I will try to take tasks in which it is necessary to make decisions and make choices more often. Of course, sometimes these decisions will be essential and responsible, but this will have an even more positive impact on my independence. For example, I will take responsibility for drawing up a treatment plan for patients and independently make decisions to monitor their recovery.

I will develop my strong side, such as communication, by constantly maintaining friendly, positive contacts with patients and medical staff. I will give helpful advice if I am asked for it to inquire about the health status of patients whom I supervised after their discharge. I will also try to meet my colleagues more often in an informal setting, for example, go to the movies or for walks with them.

In most cases, I am confident in my decisions, actions, and deeds, but I will continue to develop this strong side. To do this, I will recognize my achievements and gratefully accept praise from colleagues and patients. In addition, I will draw up a detailed plan for training and developing my nursing skills. Moreover, I will always strive to achieve what I want by any means.

Among my weaknesses, I single out my straightforwardness, which often manifests itself in adverse situations, but it must be combated. In a dispute or a problematic situation, I will pull myself away from straightforward statements in order not to spoil relations with other people. There are times when I feel that it is quite difficult to restrain myself. In this case, I will take a break in negotiations, go for a walk for a few minutes, and carefully consider the current situation and the ways to solve it. I will apply the same solution to my excessive emotionality.

To get rid of excessive self-criticism, I will praise myself for achieving goals and those situations I have positively shown myself. Furthermore, I will think about my actions more carefully to minimize the possibility of mistakes so as not to criticize myself in the future. Moreover, it will be helpful to exclude as much as possible from the circle of communication those people who notice even the most minor mistakes and give me negative emotions.

It is challenging for me to refuse people if they ask for something. Sometimes it brings me a lot of inconveniences and problems. This weakness can be eliminated by learning to say people no. Naturally, if patients come to me, I will carefully consider their request and weigh the consequences they will incur for me. It is important not to spoil relations with the environment, colleagues, and patients in this case.

In conclusion, each person needs to develop their strengths and get rid of their weaknesses. It is necessary to clearly define them and make a detailed plan for changing and improving it. This will probably make life better and the career more successful. Every day, people need to do at least something that will bring them closer to their goal, even if only one step.

The movement for social action has been gaining quite a momentum over the past decade. With the rise in the levels of agency among general audiences, the importance of issues associated with environmentalism has risen, hence the increase in the popularity of Greenpeace USA, one of the largest environmentalist organizations. Located in Washington, D.C., Greenpeace has contributed to a rise in awareness about the need to preserve wildlife and unique habitats that are currently termed as endangered (Greenpeace, 2020). Helping the species that face extinction to survive and thrive, Greenpeace has been the face of the environmentalism movement.

Action Plan

In order to make an even greater difference in the modern world, where the role of production and, therefore, the performance of numerous industries and their negative impact on the environment, has increased, Greenpeace will need a strong action plan. Currently, the company will have to focus on building awareness in a subtle yet effective manner. For this purpose, the organization will have to utilize social media tools in order to grab the audiences attention. In addition, the development of applications that will allow engaging citizens into the conservation of the environment, such as the tools tracking their environmental footprint, will be needed (Alam, Nilan, & Leahy, 2019; Hawken, 2007). Moreover, Greenpeace will have to attract funding by outlining its progress, including the effects made of the D-Town Farm and other Greenpeaces projects. By raising the attention and investment of citizens, Greenpeace will be able to create more communities such as the Damascus citizens group (Damascus citizens for sustainability, n.d.). Overall, the rise in the levels of awareness is expected to occur as a result of a massive media campaign. In addition, Greenpeace may need to emphasize the necessity to address environmental issues in light of the current range of health concerns, namely, the effects of the pandemic.

References

1. Alam, M., Nilan, P., & Leahy, T. (2019). Learning from Greenpeace: Activist habitus in a local struggle. Electronic Green Journal, 1(42), pp. 1-18.
2. Damascus citizens for sustainability. (n.d.). Web.
3. Greenpeace. (2020). About us. Web.
4. Hawken, P. (2007). Blessed unrest: How the largest movement in the world came into being, and why no one saw it coming. New York: Penguin Books

Executive Summary

The main aim of this audit report is to asses the current waste management system to outline a new plan with follow-up actions. This report entails a combination of audit results and findings. It also provides an insight into the SP AusNets general performance of office compliance. It gives a cumulative summary of existing opportunities and cost-saving recommendations. Besides, the report outlines the protocols and procedures for conducting waste management audits such as visual inspection of the current waste boxes and disposal bins. In the report, notes and photos were taken for future reference. After conducting a high-level scope analysis and inspection on the 31st of January 2014, it is apparent that the waste management industry can improve its environmental performance and compliance by undertaking several actions such as:

1. Encouraging employees to dispose of wastes appropriately.
2. Ensuring that wastes from offices are stockpiled and disposed of in an environmentally-friendly manner.
3. Avoiding extra costs by separating recyclable wastes and putting them in different waste bins.
4. Encouraging re-use by recycling more wastes and using fewer raw materials.
5. Seeking and promoting initiatives so that decimate the use of raw materials.

Background

Previously, there was a lack of data on waste composition. Therefore, the waste audit exercise was carried out to identify, classify and examine the composition of wastes emitted within the SP AusNets offices. The analysis was done on individual waste streams and those generated from collective functional zones within the organisation. The latter was also meant to ensure compliance with the requirements set by EPAs regulations.

The audit report was meant to determine the generators ability to reduce, avoid and recycle materials from the waste streams. Additionally, the audit report aimed to support the need to strengthen recycling plans and provide a guideline for a waste reduction program. Also, the waste audit entails measuring the quantity of waste production, identifying composition, and how wastes are produced. The waste audit focused on management policies and decisions related to waste production.

SP AusNet possesses and manages Victorias power transmission network besides owning electricity gas and supply networks. Approximately, there are 1800 members of staff out of which 300 operate within the city offices. SP AusNets offices are situated in Freshwater Place Southbank. It is worth to mention that the edifice has a total of 36 levels. SP AusNets employees occupy four of them.

Methodology

The waste audit exercise was carried out on the 31st of January 2014. The assessment of site comprised of three individualised visual inspections. The first inspection was conducted at 9:30 am when all the employees had already begun working. This time was deliberately selected to see the amount of garbage brought into the site from numerous cafes and restaurants in the surrounding areas. The second visual inspection took place at exactly 2:30 pm since lunchtime begins from 12 pm to 2 pm. The third and final inspection was carried out at 5:30 pm because most of the workers had finished their tasks and left the site. The high-level scope analysis carried out revealed that the wastes were not sorted manually.

1. Printer Area No. 1
2. Kitchen and Lunchroom
3. Printer Area No. 2

9:30 am: Visual Inspection

During the first visual inspection, the initial analysis was done on the employees operating area. In the site, there were desks and small cardboards and VISY paper recycling bin. Upon careful analysis, one could see stains of food in the paper recycling bins. This indicated that employees used the paper recycle bin as food scrap and coffee cups bin. This could be attributed to the fact that they were to leave their station and walk to the nearest general organic bin where they could dispose of food scraps and wrappers. However, the only general organic bin was located at the kitchen and Printing Area 1.

2:30 pm: Visual Inspection

The second visual inspection was conducted on Printer Area 1. This area is indeed spacious even though there are numerous bins which confuse staff members. As illustrated in Figure 2 below, there is a white cabinet that is just adjacent to the printer. The cabinet has two cutouts at the top that are used as waste chutes. There is a general waste chute which has a black polythene bag whereas the recycling bin is just plain without a bag. The waste is thrown directly into the plain recycle bin. There is a paper tray between the two chutes.

During the inspection, the recycling chute was full of the paper ream and shredded papers (See figure 2.1 below). This indicated that the bin had not been emptied for a long time.

There is a 60L green organics bin with signage stating ORGANIC WASTE ONLY. After careful observation, one could note that majority of the staff members are aware of what an organic waste means because most of the contents in the bin are banana peels and food scraps. The bin has a bag that is clear in colour, thereby making it easier for the cleaner to identify the content from other wastes. Alongside the 60L bin, there is a 120L recycling bin that is red. Its lid has a thank you sign and a struck sign at the bottom. There is an illustration of acceptable items that include aluminium, plastic, glass and bottles attached at the bottom. Due to the position of the bin, it is very hard to read or even notice the signage (See the figure below).

It is important to note that there is a 60L box for ink cartridges in Printer Areas 1 and 2. There is also an appointed staff member whose role is to change the ink cartridges. Furthermore, there are DOC Shops, secure document bin, a 120L VISY bin and cardboard box for recycling papers in Printer Area 2.

The lunchroom and kitchen areas on level 32 have a 60L green organics bin. The bin is hidden in one of the corners between the wall and the fridge. Moreover, there is no signage above or around this bin. Therefore, it completely relies on employees knowledge to understand and dispose of acceptable wastes. The recycle bin in the kitchen is a chute which is also part of the cupboard. The signage in the bin is visible and very detailed, as shown below.

During this visual inspection, the staff members had taken their lunch and went back at their work stations. When taking photographs through the area, it was found out that the recycling bins at the desks had a minimal litter. There were several litter bins with tissue papers, plastic boxes and food scraps. In Printing Area 1, the volume of wastes in general and recycling bins increased.

5:30pm: Visual Inspection

At this time, most staff members had gone home and therefore. It was easier to do the waste audit. In the desk, recycling bin, papers and post notes were the most common type of litter. More paper and paper reams were being recycled in Printer Area 1 whereas there was no increase of wastes in Printer Area 2.

Key Findings

Existing waste systems

The following is a summary of the current litter/recycling systems used at SP AusNets offices.

Printer Area 1 Waste Stream System

Printer Area 2

Kitchen and Lunchroom Area

Desks

Data based on historical records

Waste Profile

The following provides the data from the 24 hour waste assessment per stream

Printer Area 1

Kitchen and Lunchroom

Discussion

Preliminary site visit

All the sites were available for visual inspection as planned. The assessment was done on the bins and photographs also taken to facilitate high-scope analysis. It was found out that the latest waste audit was done way back in 2008. Hence, the present management plan was outdated. There were no costs or invoice for waste disposal records.

Site Analysis

There were too many bins in Print Area 1 of level 32. The bins were also too close to each other. Therefore, they needed to be redesigned to ensure that they had visible signage and different colours. Bins in Print Area 2 required visible signage. There was a need to reposition the bins in the Kitchen and Lunchroom to minimise contamination levels.

Individual recycling streams

Employees need to be made aware of acceptable materials to be disposed of in various waste bins to avoid excessive contamination. Moreover, employees should be keen to check the signage to understand what should be disposed of in organic bins.

Specific Issues

Establishing a centralised approach will help in reducing contamination and minimise recycling costs. Bins should be positioned in a manner that is convenient for use by employees. Moreover, they should be emptied regularly to avoid overflow and spread of unwanted papers around the printer or on the floor. Some signage, especially at the kitchen, should be made clear and visible.

Cost Saving

Communication and awareness will help employees to avoid wastage of time while dealing with confidential documents. Employees should also make use of storerooms to store waste materials and reduce frequent waste collection. Putting clear and correct signage will reduce contamination and the expenses of waste disposal.

Photographs

Opportunities

Some of the opportunities to improve the management of waste products include:

1. Avoiding waste of papers by embracing double-sided printing.
2. Reducing unnecessary printing.
3. Use of energy-efficient equipment to reduce energy costs.
4. Specifying equipment before buying to minimise overspending.
5. Undertaking regular service and repairing of equipment to reduce the cost of buying new ones.
6. Embracing the e-waste management program.

Recommendations

1. Put posters to inform staff members about acceptable and unacceptable trash
2. Update and make signage clear and visible in all the bins.
3. Send memos and emails emphasising the importance of recycling waste papers.
4. Implement staffs awareness day on waste management.
5. Use different coloured bins to avoid waste contamination.

Introduction

The United Arab Emirates (UAE) experiences climatic fluctuations from time to time. The regions high population is a contributing factor to rapid climatic change. Other aspects affecting the climate in the UAE include increased temperatures, rising sea levels, heavy precipitation, and shrinking glaciers. Furthermore, intense elements contribute to global warming, which results in acidity, drought, scarcity, and rising sea levels. The climatic change increases the countrys vulnerability, especially in the coastal areas, water factors, and dryland ecosystems. Moreover, the government of the UAE has aligned climatic mitigation plans such as the adoption of renewable energy, controlling emission of gases, and cultivation of technologies. Thus, climatic change is a problem for the UAE, and the following climate action plan could keep the climate situation under control.

Impacts of Climate Change and Underlying Physical Processes

Intense climatic changes in the UAE cause formation of greenhouse gases like carbon which then cause global warming. The coastal areas experience high temperatures and humidity, which lead to increased sea levels. Higher sea level as caused by direct sunlight makes the coastal region hot and arid. Indeed, the humidity of the coastal line could go up to 90% (Hereher, 2020). The major causes of increased temperatures in the coastal area are reclamation, oil-related activities, and dredging, which also endanger the ecosystem. The communities in the coastal regions witness changes in storm movement, intensity, and frequency. Increased sea level is experienced when the ocean warms and increases the sea surface temperature, which in turn leads to thermal expansion and change in sea levels (Hereher, 2020). Consequently, changes in sea surface temperatures lead to coral bleaching that harms the sea species. The general impact of change in sea levels affects the infrastructure, population, and sea biology.

Another significant impact of climate change is the presence of natural disasters and disruption of water resources. Global warming increases the UAE temperatures and causes unequal distribution of water resources (Al Mehairi, 2019). Following the change in the balance of water demand and supply, some regions may experience floods while other face water shortage at the same time. In agriculture, increased weeds, higher temperatures, and the presence of harmful insects cause damage to some crops (Al Mehairi, 2019). Consequently, the region experiences food shortages, and more of the lack is expected in the future. Natural disasters like floods spread salty water and contaminate the fresh waters hence endangering freshwater species and making farming impossible.

Climatic fluctuations also affect human health, animals, and plants way of living. The emission of greenhouse gases causes harm to human health by bringing respiratory diseases and other health problems. Erratic precipitation also makes the existing waterborne disorders even worse. Animals and plants shift their habitats to the mountainous and northern areas. Therefore, those that cannot migrate due to topographical obstacles die, thus posing a danger to their population.

Massive air pollution alongside other factors like water shortages and increased temperatures affect city life. In the summertime, people in the cities use energy in air conditioning and high consumption of water to quench thirst. The use of energy adds emission of carbon gases, and increased use of water contributes to water shortage (Hereher, 2020). The high population recorded in the UAE cities impacts the level of air pollution. Compared to America, where an individual emits 14 tonnes of carbon gases, the UAE emits 88 tonnes per capita (Intended Nationally Determined Contribution, 2015). Furthermore, there are many sources from which the gases are emitted, but the major one is cars. Some power stations and air conditioners used in the UAE are produced with carbon-based fuel, thus adding danger to human consumptions.

Vulnerability of Climate Change Impacts

UAE is ranked as highly vulnerable to the impacts of climate change in the world. The presence of general high temperatures makes the region more likely to experience drought (Hereher, 2020). During summer, the tree and plants dry, water becomes scarce, and animals suffer from thirst. The increased temperatures also make the dry land animals die from lack of food and water. Henceforth, the natural resources of the UAE during drought are usually at risk. The increased demand for water associated with shortage makes the lives of people difficult. The desert weather also makes the area vulnerable to less precipitation, warmer weather, increased storms, and higher sea levels.

The population and economic growth in the UAE increase the demand for natural resources, water, and energy. The provision of the three components highly contributes to the emission of greenhouse gases. Therefore, as the need for these factors increases, the level of emitted gases goes high. UAE plays a significant role in providing fossil fuels at an international level (Hereher, 2020). Consequently, the country has an excellent task of controlling the emission of gases while still delivering the energy to keep the economy stable. The vulnerability of this country places aspects like human health, natural habitats, and infrastructure in emanate danger.

Air pollution caused by emitted gases makes human health vulnerable. As the country continues to control the emission of gases, it still has to produce fossil fuels for the rest of the world. Cars are the major emitters of the carbon gases inhaled by the UAE population (Bernabeo et al., 2018). Inhalation of polluted gases puts the lives of people in health danger. Some of the emitted gases cause chronic diseases like cancer, thus threatening human existence. As the country puts measures to control gas emission, it still has to keep the economic growth constant, which is highly contributed by the sale of fuel. Human health in the country is at risk As the actors try to balance the effect of economic growth and control of gases.

Mitigating Factors for Climate Change

The UAE has considered several mitigating factors in response to climate change in the country. The measures are taken and yet to be implemented aimed at minimizing the effect of global warming in the country and the world at large. The climate-troubled government seeks to control the emission of carbon gases. Henceforth, it has engaged 14 projects whose primary purpose is to reduce the emission of gases (Mfarrej, 2019). The projects plan is to cut the gases by at least one million tonnes, whereby the adoption of renewable energy is a key contributor. The initiative also aims at expanding the role of low-carbon technologies, thus ensuring the use of nuclear power and renewable energy.

The UAE is also considering the application of cultivation technologies that seek farming without using soil. The initiative will curb the effects of harsh agricultural products and the damage to the ecosystem. According to Ajaj et al. (2019), the technology controls domestic climate change such as temperatures, ventilation, and humidity. It also helps in the roots environment whereby it selects adequate media for the roots to grow (UAE, 2020). Furthermore, cultivation technology increases the efficiency of fertilizer use, water consumption, and solutions for soil type and soil problems. Through the use of the technology, local farming will be enhanced, thus preventing food shortages in the future.

The country seeks to reduce the flaring of natural gases by not burning waste materials. When waste materials are burned, they also emit toxic gases that cause global warming. According to Mills and Sim (2021), flaring often occurs in oil and petrol-producing industries, so the use of renewable gases and nuclear power will reduce the flaring. Another measure is increasing the efficiency of energy use in various industries. The government of UAE approved projects like Smart City Strategy, Green Building, and Sustainable Building Standards, and many others to improve the use of energy (Mills & Sim, 2021). The initiative aims at ensuring good use of energy in communication, transportation, urban planning, financial services, and infrastructure. The Masdar initiative will develop and commercialize technologies for renewable energy, water usage, carbon management, and desalination (United Arab Emirates First NDC, 2020). The above are the most efficient mitigation measures to curb climate change in the country.

Conclusion

Climate change has brought many implications to the United Arab Emirates. Global warming affects natural resources as well as human health, thus making its increased changes worse. Climate change causes drought, scarcity, diseases, and air pollution, among other effects. The UAE is highly vulnerable to climate change due to its arid weather and production of fossil fuels in large volumes. However, the country government has placed many adaptation measures amongst which are already in practice. Adoption of cultivation technology, efficient use of energy, and use of renewable energy are among many measures. The country is expected to experience increased levels of climate change hence the need to act immediately. With the mentioned mitigation strategies in place, the UAE will cut gas emissions in large volume, thus reducing climate change.

References

Ajaj, R. M., Shahin, S. M., & Salem, M. A. (2019). The challenges of climate change and food security in the United Arab Emirates (UAE): From deep understanding to quick actions.Current Nutrition & Food Science, 15(5), 422-429. Web.

Al Mehairi, J. (2019). United Nations convention on climate change and UAEs efforts towards it. In Health and Environment Conference (289-301). Web.

Bernabeo, R. A., Khalifeh, H. A., Andretta, A., Al Khatib, I. T., & Ghori, M. H. (2018). The impact of climate change and weather on air transport in the UAE: Reduction of CO 2 emissions. In 2018 Advances in Science and Engineering Technology International Conferences (ASET) (pp. 1-7). IEEE. Web.

Hereher, M. E. (2020). Assessment of climate change impacts on sea surface temperatures and sea-level riseThe Arabian Gulf.Climate, 8(4), 50. Web.

Mfarrej, M. F. B. (2019). Climate change patterns in the UAE: A qualitative research and review.Nature Environment and Pollution Technology, 18(1), 261-268. Web.

Mills, R., & Sim, L. (Eds.) (2021). Low carbon energy in the Middle East and North Africa. Springer Nature.

UAE. (2020). Climate change. Web.

Intended nationally determined contribution of the United Arab Emirates. (2015). Web.

The organization under analysis is Eisenhower Health Center

Eisenhower Health Center is an acute care facility in southern California. It is a progressive 463-bed hospital. Its mission is to serve the changing healthcare needs of the region by providing excellence in patient care with supportive education and research (Eisenhower Health, n.d.). The organization was rated with five stars by the Medicare website, which is a sign of the quality of care provided by the healthcare facility. Eisenhower Health Center has a culture of constant improvement, which makes it an excellent target for implementing a change program.

Problem Statement

In the hospital settings, one of the major concerns for healthcare managers is pharmaceutical products management and distribution. According to recent studies, one of the leading causes of severe complications is adverse drug events (ADEs) due to unaccounted drug-to-drug interactions (Toivo et al., 2016). ADEs are most frequent among older adults due to polypharmacy (Earl et al, 2020). Thus, the central purpose of my capstone project will be to create an initiative that will decrease the number of ADEs among older adults.

Proposed Solution

There are different approaches to reducing ADEs among older adults. They include introduction of protocols and algorithms that support the decision-making process, direct education to patients, and medication reviews by pharmacists or clinicians. I propose a dual approach to the problem by introducing a clinical decision support system and provision of direct education to patients about ADEs. The solution of the problem was inspired by the National action plan for adverse drug event prevention published by the US Department of Health and Human Services (HHS, 2014). The policy recommends that education programs should concern anticoagulants, diabetic agents, and opioids, strict guidelines should be adopted to promote safe medication use, and organizations should monitor adherence to the guidelines. Thus, the action plan will be based on these recommendations.

ECLIPSE Question

Asking the right question is crucial for acquiring support for clinical practice. Thus, the principles of evidence-based practice require that the clinical question is formulated precisely to ensure that evidence can be translated into practice. There three mnemonics that are usually used for formulating clinical questions, including PICO (population, intervention, comparison, outcome), ECLIPSE (expectations, client groups, location, impact, profession, service), and PECOT (population, exposure, comparator, outcome, time period) (International Center for Allied Health Evidence, 2016). The proposed project will use the ECLIPSE mnemonic to ensure that the question includes all the vital elements of a well-built question.

The problem I am trying to address in my capstone project is adverse drug events (ADE) among older adults. Thus, the primary expectation (E) of the program is a decreased number of ADEs. The client group (C) is older adults, and the location (L) is the Eisenhower Health Center, as I used the healthcare facility for my previous projects. The impact (I) of the program will be similar to the expectation, as the success will be measured in the number of ADEs. The profession (P) is the front-line personnel, including nurses and physicians. The service (SE) under analysis is the provision of patient education about the prevention of ADEs. Thus, the ECLIPSE question is:

Will patient education about the prevention of ADEs provided by nurses and physicians decrease the number of ADEs among older adults in the Eisenhower Health Center?

Evidence

Medline and Cochrane databases were used to acquire evidence. The utilized keywords included adverse drug events, prevention, patient education, reporting. Even though the search generated more than 2000 results, the majority of studies were excluded as they did not relate to the topic of interest.

The results of the literature revealed that ADEs is a topic of increased interest among scholars and care providers. However, currently, patient education is not a popular method for reducing morbidity from ADEs. Medication review was the most common intervention to address the problem of ADEs (Tecklenborg et al., 2020). At the same time, the literature review revealed that education intervention is associated with decreased morbidity from ADEs (Ducoffe et al., 2016; Joshi et al., 2015; Khalil & Huang, 2020; Pagotto et al., 2013; Tecklenborg et al., 2020). In particular, patient education increases timely ADE reporting, which decreases morbidity and mortality (Ducoffe et al., 2016; Joshi et al., 2015 Pagotto et al., 2013). Additionally, it was found that patient education of older adults can decrease the occurrence of adverse drug events and the chances of opioid overdose (Tecklenborg et al., 2020; Khalil & Huang, 2020). Patient education was found to work well with other interventions, including drug reviews.

Goals and Timeline

There are at least three goals that can be identified for the project. First, the project aims at increasing the awareness among care providers about adverse drug events. Second, the project will improve the ability of frontline medical personnel to provide patient education concerning ADEs. Finally, the central goal of the program is to decrease the number of ADEs among older adults. Achievement of these three goals is expected to decrease morbidity and mortality from adverse drug events among older adults.

The project is expected to take almost six months. The implementation of the project will be based on the Diffusion of Innovation (DOI) theory. In 1962, E. M. Rogers identified five types of people, depending on their readiness to adopt change (Lien & Jiang, 2017). According to the theory, there are innovators (2.5%), early adaptors (13.5%), early majority (34%), late majority (34%), and laggards (Lien & Jiang, 2017). The theory includes three major steps, which are awareness, initial use and prolonged use (Lien & Jiang, 2017). Base on DOI, the proposed timeline is the following:

1. January 4, 2021: Program start
2. January 4, 2021  January 31, 2021: The dissemination stage
3. February 1, 2021- February 28, 2021: Needs assessment and intervention planning
4. March 1, 2021  May 31, 2021: Provision of ADE education
5. June 1, 2021  June 14, 2021: Assessment of results. Consideration for further use
6. June 15, 2021: Project End

Financials

The initiative is expected to have a significant financial impact. In particular, it will require some resources for providing education to care providers and increase awareness about the necessary of change. The initiative will not require significant financial investments, as it is an educational project. However, there are some expenditure the Eisenhower Health Center will need to cover. First, every front-line employee will be required to finish a two-hour training course about how to provide patient education about adverse dug events. This will be associated with around $8,000 in cost associated with hiring a certified trainer and losing some productive hours of the personnel. Second, the facility will need to cover the expenses associated with the dissemination stage. During this stage, Eisenhower Health will conduct meetings, make posters, and email information concerning the problems with adverse drug events. This implies, the meeting rooms and equipment for presentations will be needed. The overall cost is expected to be around $2,000. Finally, the facility will need to pay for extra working hours of the change leader. They are estimated at $5,000 in total.

While the initiative is associated with several costs, it can bring some financial benefits. Currently, the cost of every adverse drug event is at least $2,000, including prolonged hospital stay and decreased reimbursements (Bhat & Udupa, 2016). Reduction in ADEs will lead to several changes, that can be converted into cash. First, decreased number of ADEs will decrease the average hospital stay. This will allow the hospital to serve more patients with the same resources. This will lead to increased revenues. Second, ADEs are often considered as the fault of the organization, which leads to reimbursement problems. Thus, the initiative will decrease the amount of bad debt by reducing the number of non-reimbursed services. Finally, decreased number of ADEs will lead to improved quality of provided care, which will improve the facilitys reputation. This can also be converted to financial benefits.

Legal and Ethical Considerations

The initiative is not expected to experience any significant ethical of legal issues. However, there are two points should be noted during the implementation. First, the program should be congruent with the National action plan for adverse drug event prevention developed by the US Department of Health and Human Services (2014). Additionally, patient education should be provided only if the patient agrees.

Goals and Milestones

The goal of the project is to decrease the number of ADEs among older adult patients. The goals is expected to be achieved by achieving the following objectives:

• Disseminate information about the impact of ADEs;
• Develop a patient education program about ADEs for older adults;
• Provide training for frontline personnel;
• Implement the new patient education program;
• Evaluate the program.

The project is expected to have the following milestones:

• January 4, 2020: Project Start; Dissemination phase starts.
• February 1, 2020: Needs assessment and intervention planning phase starts.
• March 1, 2020: Implementation phase starts.
• June 1, 2020: Evaluation phase starts.
• June 15, 2020: Project close.

Measures of Progress

The success will be measured using two variables.

The first variable will be the prevalence of ADE cases among older adults in percent. The variable will be measured using a pre-test post-test methodology. After receiving the results, statistical analysis will be used to understand if the change was significant.

The second variable will be the approval of first-line personnel. There is a high probability that statistical analysis will not detect the change, as the timeframe is rather small. Thus, an additional variable may be needed to assess the effectiveness of the intervention. This variable will be measured by asking the front-line personnel if they believe that the program was beneficial. If 80% or more agree that the intervention is beneficial for older adults, it will be considered a success.

Information

Four types of information will be gathered to measure the success of the program. First, the prevalence of ADE among older adults will be measured using electronic health records (EHRs). The data will be collected automatically using the hospital database. Second, adherence to the initiative will be measured by asking patients if they received education about ADEs. Third, employee approval will be measured by asking the front-line personnel if they believe that the intervention is beneficial for the target population. The assessment will be conducted using Google Forms. This survey will be one of the measures of success. Finally, patient satisfaction will also be measured by conducting surveys to see if provided education affected it.

Audience

Before articulating the communication plan, it is crucial to understand the audience. The audience of the present communication plan includes different groups of stakeholders.

First, the project will be steered by the project management team. The primary interest of the management team is to implement the change with maximum efficiency, which implies that there is low chance of resistance from these stakeholders.

Second, the project will need to be approved by the board of directors. This stakeholder provides the money for implementation with the primary aim to receive returns on investments. The interest of the stakeholder is to improve efficiency and quality of provided services. Thus, medium resistance is expected due to the possibility of distrust with methods.

Third, care providers are the central stakeholders as they will need to implement the change. Their primary interest is personal growth and receiving money for their services. Since they will not be paid for providing patient education, they are likely to be the source of resistance.

Finally, trainers are another crucial group of stakeholders who will deliver training to the care providers. Since they will be paid for their service, there is a small chance that they will be a source of resistance.

Progress Communication

Even though the project requires the participation of multiple stakeholders, the communication plan is expected to be rather simple due to the straightforwardness of the action plan. There are expected to be three aspects of communication. First, there will be only two live meetings, at the beginning, and at the end of the project. All the major stakeholders will be invited to these meetings, including the board of directors of Eisenhower Health, the project management team, and front-line personnel. Formal progress report meetings will be held every first Wednesday of the month, where the project manager will provide a comprehensive assessment of the project. The meeting will be held in Zoom, where everyone will be provided with a formal document designed to outline the current state of the initiative. Apart from meetings, all the stakeholders will be able to communicate at any time via messages in a WhatsApp chatroom that will be created with all the stakeholders.

Change Management Plan

The desired change can be successful only of closely management throughout the implementation. The change management plan for the initiative will include four stages. During Phase 1, the desire for change will be aroused in all the stakeholders. This will be achieved by conducting an assessment of the current situation about ADEs in Eisenhower Health and explaining the findings to the stakeholders. The need for change is usually aroused using effective communication, including meetings, posters, and motivating emails. All of these will be used in the first stage of the change management plan.

During Phase 2, the change plan will be created using the ideas of all the stakeholders. The plan will include detailed information about training schedules and ongoing assessments.

Phase 3 is the implementation of change, which implies that it is a very active change. During this stage, the change will be tailored using ongoing assessments and on-demand coaching.

The final stage will include assessments of the results to evaluate if the change was successful. During this stage, a decision will be made if the change was beneficial, and if the practice should be continued.

Post-implementation Communication

Post-implementation communication will consist of two aspects. First, all the stakeholders will be provided with a final report. This is a formal summative document that will include the analysis of results, including changes in the occurrence of ADEs, adherence to the new practice, and expected financial benefits. The report will also provide recommendations about if the new practice of providing patient education about ADEs to older adults should be continued.

The second aspect of post-implementation communication is the final meeting of stakeholders. During this meeting, the stakeholders will ask questions about the final reports and decide if the project was successful and the new practice should be continued.

References

Ducoffe, A. R., York, A., Hu, D. J., Perfetto, D., & Kerns, R. D. (2016). National action plan for adverse drug event prevention: recommendations for safer outpatient opioid use. Pain medicine, 17(12), 2291-2304.

Earl, T. R., Katapodis, N. D., & Schneiderman, S. R. (2020). Reducing adverse drug events in older adults. In Making healthcare safer III: A critical analysis of existing and emerging patient safety practices [Internet]. Agency for Healthcare Research and Quality (US).

Eisenhower Health. (n.d.). About us.

International Center for Allied Health Evidence. (2016). Elements of a well-built question. 

Joshi, A., Shah, N., Mistry, M., & Gor, A. (2015). Evaluation of knowledge and perception toward adverse drug reactions among patients visiting tertiary-care teaching hospital. National Journal of Physiology, Pharmacy and Pharmacology, 5(4), 280.

Khalil, H., & Huang, C. (2020). Adverse drug reactions in primary care: a scoping review. BMC Health Services Research, 20(1), 5.

Pagotto, C., Varallo, F., & Mastroianni, P. (2013). Impact of educational interventions on adverse drug events reporting. International journal of technology assessment in health care, 29(4), 410.

Tecklenborg, S., Byrne, C., Cahir, C., Brown, L., & Bennett, K. (2020). Interventions to reduce adverse drug event-related outcomes in older adults: A systematic review and meta-analysis. Drugs & Aging, 37, 9198

Toivo, T., Mikkola, J., Laine, K., & Airaksinen, M. (2016). Identifying high risk medications causing potential drugdrug interactions in outpatients: A prescription database study based on an online surveillance system. Research in Social and Administrative Pharmacy,12(4), 559-568.

US Department of Health and Human Services. (2014). National action plan for adverse drug event prevention. Health.gov.

Problem Overview

Due to a considerable influx of immigrants, the community has to meet a number of challenges in order to satisfy health care needs of the group and ensure their access to all necessary services. For this purpose, an action plan has to be developed. It will allow setting priorities for further work and engaging community members in the implementation process, the outcome of which will determine whether immigrants and refugees will have a chance to settle, find jobs, and belong.

Issues to Be Considered

The following issues need to be considered, changed or planned for the community and the health care facility (García-Pérez, 2016):

• The community must strengthen settlement support for immigrants by reinforcing settlement systems and coordination of services. Effective collaboration between all community sectors is necessary to ensure accommodation.
• The community in general and the health care facility in particular must render health care support for immigrants by increasing access to services and providing insurance benefits.
• It is essential to foster communication by fostering language education. The community should offer linguistic courses to newcomers while the hospital must ensure culture-competent care.
• The lack of navigation among different organizations and services has to be addressed.

Change Model

Before passing to the development of the succession of steps to achieve better health outcomes for the selected group, it is crucial to choose the most effective change model that would make it possible to collect all relevant information, assess the needs of immigrants, and translate theoretical knowledge into practice. This has to be performed for developing a structured approach to change since new data must be integrated into the existing corpus of knowledge, which is practically impossible without systematization.

The ACE Star Model was selected as it provides a comprehensive step-by-step framework for addressing the needs of the population group:

1. At the first stage profound research about immigrants major needs and problems has to be conducted by both social and health care workers.
2. The second stage involves summarizing all the data and evidence obtained.
3. At the third stage, the collected knowledge is applied to develop practical guidelines that would allow addressing risk groups, finding ways to ensure access to health care services, developing policies, and ensuring culture-competent care.
4. The fourth stage presupposes implementing the developed guidelines in clinical practice.
5. The fifth, final stage of the change is devoted to evaluation of the achieved outcomes. All the mistakes are to be analyzed and corrected. The major indicators to be measured are the increased access to health services and improved quality of care.

Second Order Change Factors

While first order changes imply dealing with the existing structure of the community and the challenges it presents for immigrant adaptation, second order change presupposes an entirely new way of approaching the problem. It will bring about new vision of the issut. For achieving this, the following factors have to be considered (Hacker, Anies, Folb, & Zallman, 2015):

• the attitude of the community to immigrants and the willingness of its members to assist them in the process of adaptation;
• involvement of hospital administration;
• interest of policy makers;
• active policies and campaigns launched by higher authorities;
• effective coordination between social and medical institutions.

The impact of the change will be better quality of care for newcomers as well as facilitated ways of assessing medical services and getting insurance. Moreover, it will result in the improved population health and public services. However, there are still numerous barriers to be taken into account. They include legal problems with registration, policy limitations for illegal immigrants, lack of funding, social assets, change resistance on behalf of the community, and lack of the governments attention to the problem (Hacker et al., 2015).

References

García-Pérez, M. (2016). Health Outcomes, immigration, and development converging to American: Healthy immigrant effect in children of immigrants. The American Economic Review, 106(5), 461-466.

Hacker, K., Anies, M., Folb, B. L., & Zallman, L. (2015). Barriers to health care for undocumented immigrants: A literature review. Risk Management and Healthcare Policy, 8(1), 175-189.

In view of the growing usage of electronic and mobile information technology, educational institutions are re-examining permissible use guidelines. While acceptable usage policies were created to govern and control behavior, a digital citizenship plan requires a more holistic approach by acknowledging the critical value of education in developing digital citizens. The goal of the guideline plan is not to impose policy, but to provide guidance to executives as they work to better fulfill the needs of students and organizations. The objective of the action plan is to help school districts build a digital citizenship action strategies and policies to meet students demands. Furthermore, to provide policy creation guidance to aid in the protection of students operating in open, participatory, online contexts.

A digital citizen is a citizen who participates in society, economics, and government via the use of digital technologies. Teachers must be ready to play a key role in developing digital citizens that can participate ethically in the creation of a fairer world (Buchholz et al., 2020). In terms of the development of a concrete digital citizenship action plan, it is possible to identify several steps, or focus points. Firstly, it is necessary to underline digital access, which is total and ubiquitous online participation in the social context. In this case, the following question arises: Is the education department capable of teaching digital citizenship, or will it require to provide development opportunities to do so? Secondly, it is compulsory to highlight digital communication since instructors should have meaningful discussions regarding the role of current communication methods in educational contexts. Exact questions can be emphasized: What type of direction do students obtain from the school authorities in terms of acceptable communication? Do public communications via Web 2.0 and social networks have realistic expectations? In this situation, the aspects of electronic communication procedures should be clearly formulated.

Concerning digital citizenship action plan elaboration, with a particular focus on social media and networks, it is feasible to emphasize several steps. The notion of digital citizenship arose from the fact that social media has increased the mobility of people lives to the point where contact between them is nearly limitless. For instance, it can be proposed to improve educational processes in terms of learning to type, using a computer mouse, and other computer abilities. In addition, it is recommended that when communicating with individuals online, people should be educated to avoid harassing or hate speech in the digital sphere. Moreover, people and their communities should be encouraged not to unlawfully download or copy information or disrespect intellectual property in any other way. Considering institutions and schools, it is essential to highlight the importance of internet etiquette and the need for each person to safeguard their personal information. Thus, a specific focus on communications via platforms and programs in the social networking field is obligatory for the implementation of the digital citizenship policy.

To summarize, several phases, or emphasis areas, may be identified in the construction of a concrete digital citizenship action plan. To begin, it is important to emphasize digital access, which refers to entire and pervasive online engagement in social situations. Secondly, because instructors should engage relevant dialogues about the importance of modern communication technologies in educational contexts, it is imperative to highlight digital communication. The components of electronic communication processes should be explicitly stated in this circumstance. The concept of digital citizenship originated as a result of the increased mobility of peoples lives as a result of social media, to the point where communication between them is practically endless.

Reference

Buchholz, B. A., DeHart, J., & Moorman, G. (2020). Digital citizenship during a global pandemic: Moving beyond digital literacy. Journal of Adolescent & Adult Literacy, 64(1), 11-17.

Introduction

For a modern person who claims to be cultural and educated, low culture of communication should be considered as indecent as the inability to read and write. Speech is the best passport of a person, and today, new economic and social conditions have highlighted the need to increase communicative competence, since a high speech culture and a developed economy are inseparable. It is known that in many countries of the world, a great deal of attention is paid to the problem of communication. It is also important to note that today in the world, interest in rhetoric has also sharply increased. From psychological perspective the need for improvement in areas such as public speaking, negotiation, and time management is the issue of confidence. By harnessing self-confidence, a person can psychologically influence others.

Public Speaking

The first core skill that needs major improvement is public speaking because I believe it will greatly advance my career progression. I might possess the given skill due to a number of courses where I needed to present my point of view in front of a large audience. For example, during various seminar sessions my peers gave a relevant feedback which stated that my public speaking skills require major improvements. Thus, it can be said that my competence level is not fully developed to proficient degree. In fact, communication skills are becoming the so-called cornerstone for successful career growth. In addition, public speaking is important because more than one-third of respondents indicated that poor public speaking skills hindered their progress up the career ladder.

Public speaking is a powerful business tool, and due to competent and thoughtful communication, you can inspire, motivate, convince, impress, or settle any conflict (Shi et al., 2017). In addition, recently, customers are becoming more demanding and receptive in relation to their professional service, which is critical for my future career advancements. All this increases the need for effective communication skills, last but not least, with the goal of establishing long-term relationships with customers. In addition, this entails attracting new customers, which in general will increase both the companys sales level and the companys popularity in the market (Laborda et al., 2016). However, to date, not every manager can boast of good public speaking skills.

However, in my career, the task of managers is precisely to identify the needs of the staff, even if they do not know about their needs in this public speaking area or do not want to cooperate (Golombisky, 2016). The face of the company is its employees, and therefore, the ability to speak clearly and confidently is a skill that employees working at all levels of the company should have. The organization should strive for excellence, and approaches will vary depending on the needs of the employee and his role in the company.

General professional knowledge and communication experience in repeated professional situations allow the audience to replace perceived values with adequate meanings, thereby providing her with an understanding of text information at the semantics level. This can be considered as a major contradiction due to the inherent factor of randomness. Formulating their conclusions about the speakers intentions, the partners are guided not only by general knowledge about the events discussed but also use their own beliefs, opinions, and attitudes related to the circumstances under discussion for this purpose (Shi et al., 2017). This provides them with an understanding of the speakers intentions, even when these intentions are not directly expressed in speech and, therefore, cannot be understood at the level of semantics.

Negotiation

The second core skill that needs improvement is negotiation skills, especially during conflicts. The main reason is that I mostly avoid conflict, which is one of the disadvantageous resolutions. However, it is certain that I might possess a certain amount of competence in this regard due to numerous remarks from my tutors which stated that I have necessary personality-based factors, such as high level of compassion. It is important because business negotiations are a tool for establishing business relations, coordination of joint activities. Without business negotiations, the actions of specialists in many professional fields are impossible: management, jurisprudence, state, and municipal administration, commerce, politics (Wesner and Smith, 2019). The relevance of the problem is that the effectiveness of business negotiations, which make up a significant part of the professional activities of managers at various levels, is determined not only by their professional competence on the issues discussed but also by personal and business qualities.

The main goal is to study the psychological conditions for effective business negotiations, and the object of improvement is business negotiations. At my current level, the subject of development is mental conditions that affect the effectiveness of business negotiations. The biggest contradiction is the presence of social anxiety, which forces excessively polite people to avoid stressful negotiations. The effectiveness of business negotiations is determined by the business and personal qualities of managers, who are influenced by experience in the field of issues discussed, organization, and conduct of negotiations (Tomlinson and Lewicki, 2015). In the course of the modern process of globalization of the economy of our country and the strengthening of entrepreneurial activity, new perspectives are opened for expanding professional cooperation and entering the international market.

As a result, cultural exchanges, and direct contacts between government institutions, social groups, and individuals of different countries are carried out (Wesner and Smith, 2019). First of all, it is a neoplasm that manifests itself in the interaction of negotiators as carriers of certain cultures and has a complex psychological structure (Wertheim, Glick and Larson, 2019). In general, the competence of participants in business negotiations can be considered as a combination of culturally relevant values, norms, stereotypes, and social skills that ensure conflict-free, effective, and comfortable negotiation process in a multicultural environment. Thus, my future career will certainly involve negotiations due its prevalence in any management positions.

Time Management

Furthermore, it is critical for me to develop my time management skills in order to be more productive. It is important for me because time management is effective planning of working hours to achieve goals, finding temporary resources, prioritizing, and monitoring the implementation of what is planned. I might possess the given skillset because a number of my peers during self-assessment sessions noted that I am diligent with my time. However, they also pointed out that I excessively focus on unimportant tasks, which might be urgent but irrelevant. Its main task is to do more in a unit of time and effectively spend its resources. In psychology, there are two types of time management  simple and systemic (McCune, 2015). At the core of the system are global goals, which allows us to talk about time management as a philosophy of life. Simple time management is a set of techniques that help to move towards achieving these global goals gradually.

Turning to the goal-setting, it should be understood that the goal must be real, concrete, measurable, and have a deadline for implementation. If the target does not have one of these parameters, then it ceases to be the target. The ability to prioritize is the main part of time management as if each business or work is considered urgent and most important, then you will not be able to effectively plan the time (Adams and Blair, 2019). Habits are an indicator that the art of time management is mastered. However, they also can act as major contradictory factors which hinder ones ability to be productive. They will be manifested in a developed sense of time, which will help to complete all things on time and increase personal effectiveness (Wajcman, 2019). The working hours of most modern managers of modern managers are tightened to the limit, the working day is not standardized, and yet it is often not possible to complete all the scheduled tasks by the specified deadline.

In such a situation, the only solution can only be the use of special techniques and methods that have the common name of time management. Time management is just a big name for what is essentially the management of oneself, an organization, people in order to accelerate the resolution of problems, the implementation of activities, the execution of work, actions (Adams and Blair, 2019). The relevance to my career is manifested in the fact that any modern occupation requires an employee with outstanding time management skills.

Conclusion

In conclusion, the mental state is holistic, at every moment, it captures a person completely. It is impossible to imagine a person simultaneously experiencing several different conditions. It is important to note that this is not about ambivalent feelings because the combination of several trends gives a new quality of experience. Identity also gravitates towards integrity, but since it is an actual combination of human relations with the world, its attitude to integrity is more complicated. Of the many available and taking place relationships with the world, a person identifies a certain aspect, that which is the focus of his attention and organizes his activity.

Reference List

Adams, R.V. and Blair, B. (2019) Impact of time management behaviors on undergraduate engineering students performance, SAGE Open, 9(1), pp. 1-11. Web.

Golombisky, K. (2016) Integrating public speaking into the advertising curriculum, Journal of Advertising Education, 20(12), pp. 122-134. Web.

Laborda, M.A. et al. (2016) The extinction and return of fear of public speaking, Behavior Modification, 40(6), pp. 901-921. Web.

McCune, M. (2015) Life 101: Time management: These two time management strategies are easy for college students to use and can generate big payoffs, Educational Horizons, 93(3), pp. 28-29. Web.

Shi, X. et al. (2017) Understanding the influence of self-critical, self-managing, and social-assessing self-talk on performance outcomes in a public speaking context, Imagination, Cognition and Personality, 36(4), pp. 356-378. Web.

Tomlinson, E. C. and Lewicki, R. J. (2015) The negotiation of contractual agreements, Journal of Strategic Contracting and Negotiation, 1(1), pp. 85-98. Web.

Wajcman, J. (2019) The digital architecture of time management, Science, Technology, & Human Values, 44(2), pp. 315-337. Web.

Wertheim, E., Glick, L. and Larson, B. Z. (2019) Teaching the basics of negotiation in one class, Management Teaching Review, 4(2), pp. 95-118. Web.

Wesner, B. S. and Smith, A. B. (2019) Salary negotiation: A role-play exercise to prepare for salary negotiation, Management Teaching Review, 4(1), pp. 14-26. Web.

Overview of hospital-acquired infections

Hospital-acquired or nosocomial infections are conditions that patients develop while in a healthcare facility and were absent at the time of admission. They are exacerbated by factors, such as the environment in which care is provided, and the condition and susceptibility of the patient (Khan et al., 2017). They are caused by bacterial, fungal, and viral pathogens. The various types of nosocomial infections include surgical site, urinary, and respiratory, and vascular catheter infections.

Epidemiology of hospital-acquired infections

• Prevalence on hospital-acquired infections globally
• Prevalence of urinary tract infections
• Prevalence of surgical wound infections
• Prevalence of ventilator-associated pneumonia
• Prevalence of primary bloodstream infections

Nosocomial infections are prevalent in healthcare facilities, with approximately 15% of admitted patients suffering from them. Urinary tract infections are the most common (36%), followed by surgical wound infections (20%) and lastly pneumonia and bloodstream infections (11%) (World Health Organization, 2002).

Prevention of hospital-acquired infections

• Importance of preventing hospital-acquired infections
• Differential hospital-acquired infection risk by patient and interventions
• Strategies to decreasing person to person transmission
• Strategies for reducing environment to person transmission
• Precautions of infection control inpatient care

It is essential to control nosocomial infections as it will lead to decreased mortality rates, readmissions, and admission costs. Depending on the immunity of affected patients, different procedures are applied as the risk of infection is variable (World Health Organization, 2002). There are several strategies for preventing nosocomial infections, and they range from person-to-person (hand decontamination, personal hygiene, personal protective equipment, and safe injection practices) to environment-to-person (cleaning, disinfecting, and sterilizing the environment).

Prevention of the frequent types of hospital-acquired infections

• Most common types of hospital-acquired infections
• Prevention of urinary tract infections (UTIs)
• Prevention of surgical sites or wound infections
• Prevention of hospital-acquired respiratory infections
• Prevention of infections associated with intravascular lines

The most prevalent types of hospital-acquired infections include surgical wounds, urinary tract, and primary bloodstream infections, and pneumonia (World Health Organization, 2002). Due to the different modes of transmission, each condition is associated with its distinct preventive strategies.

Stakeholders involved in infection control programs

• Surveillance on the rate of hospital-acquired infections
• Roles of the federal government in infection control
• Roles of the state and local government
• Roles of healthcare facilities in infection control
• Roles of patients in infection control

Nosocomial infections require either active or targeted epidemiological surveillance to monitor performance improvement in preventive and control strategies. The key stakeholders involved in nosocomial infection occurrence and control comprise the federal government, state and local health departments, healthcare facilities, and patients (World Health Organization, 2002). The federal government, with the help of state and local health departments, supports prevention programs and test innovative infection control and prevention techniques. Healthcare facilities implement protocols formulated by the health departments. Conversely, patients practice good hygiene.

Solutions to nosocomial infections, and their purpose, cost, and desired outcome

• Preventive solutions and the associated costs
• Medical solutions and the associated costs
• Antimicrobial use and resistance in infection treatment
• Surgical solutions and the associated costs
• Comparison of preventive, medical, and surgical solutions

The three leading solutions to reducing nosocomial infections include preventive, medical, and surgical solutions. Preventive solutions are characterized to take a longer duration as compared to medical and surgical solutions. Moreover, preventive strategies minimize the occurrence of infections, while the latter promotes healing. It is recommended for antimicrobial medications to be administered after a successful diagnosis as frequent use might result in resistance.

Reason for preventive strategies being more effective than medical and surgical strategies

• Prevention  the best solution to hospital-acquired infection control
• Comparison between preventive and medical solutions
• Comparison between preventive and surgical solutions
• Empirical evidence supporting preventive strategies
• The most effective type of preventive measure

Interventions exceeding 6 months are associated with higher savings-to-cost ratios (Arefian et al., 2016). Therefore, this suggests that prevention solutions are more feasible and effective as compared to preventive and medical solutions. Nevertheless, observing hand hygiene has been identified as the single most effective preventive method (Haque et al., 2018).

Action plan

Nosocomial infections are a significant problem in healthcare facilities. The primary action required is to ensure that all healthcare staff is educated on relevant preventive measures. The lead persons will be the nurses-in-charge as they will be responsible for their given units. Preventive strategies are long-term and lack an expiration date. The effectiveness of the preventive strategies will be measured by the prevalence of nosocomial infections in the facility.

Conclusion

With the increased prevalence of hospital-acquired infections and resistance to antimicrobials, the need for implementing preventive strategies is crucial. This is because these infections are linked to increased mortality rates and financial implications. The most affordable yet cost-effective method of reducing the onset of nosocomial infections is hand washing. Reflection

This paper is centered on the prevalence, implications, and solutions to hospital-acquired infections. The research and information gathered about the topic have further cemented my knowledge of such infections. For instance, it has negated my assumption on the solutions in that the expensive strategies are most effective. Therefore, if nursing professionals embrace this information, it would improve the quality of care; hence, revolutionizing the healthcare sector.

References

Arefian, H., Vogel, M., Kwetkat, A., & Hartmann, M. (2016). Economic evaluation of interventions for prevention of hospital acquired infections: A systematic review. PLOS ONE, 11(1), 1-15. Web.

Haque, M., Sartelli, M., McKimm, J., & Abu Bakar, M. (2018). Healthcare-associated infections  An overview. Infection and Drug Resistance, 11, 23212333. Web.

Khan, H., Baig, F., & Mehboob, R. (2017). Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal of Tropical Biomedicine, 7(5), 478-482.

World Health Organization. (2002). Prevention of hospital-acquired infections: A practical guide. Web.