By the time the World War II came to an end, the United States of America had begun involvement in world affairs. It was the richest and perhaps the most powerful nation at that time. Before world war two, the U.S preferred the isolationist policy to partnering with other nations on international matters.
This saw the U.S economy suffer greatly after the World War I since America had gone into the war alone. To avoid further hurting their economy, the U.S changed from their isolationist policy to an interventionist policy which was more involving as it included other nations in form of allies. It was also partly caused by the U.S. realizing that instability and lack of peace in other parts of the world would eventually affect them in one way or the other.
This triggered Americas support in the formation and hosting of the United Nations (UN). It also actively participated in the North Atlantic Treaty Organization (NATO). These were effort to ensure stability and peace as it became essential to minimize conflicts and solve them peacefully. With relative peace and stability, the U.S. could pursue its political and economic interests abroad. The main focus of this paper is to support the U.S. national interests and goals articulated after World War II.
After world war two, America equated its national interests with pursuance of world superpower status. It had invested heavily in industrialization and therefore had mass production of various goods and services. To successfully pursue its political, social and economic interests, the U.S. had to make sure that there was enduring peace and democracy across the world. The U.S. made treaties and agreements with far-flung nations.
These were countries of great interest to the U.S. in terms of trade and security; for the world order to be in place as it desired, the U.S. had to ensure it leads the way. The interventionist approach was of great benefit in helping the U.S. to enforce the new world order. For instance, the Spanish-American war in which the U.S. won within a short period of time helped in making it known as a powerful nation.
The triumph in the war was followed by the U.S. taking control of an empire in the Caribbean and the Pacific. America had laid strong foundations for prosperity long before the two world wars. American education, innovation, military and science levels were highly advanced compared to other countries. This acted as an advantage to them to accomplish their mission.
In as much as the U.S. chose to pursue the interventionists approach internationally, diplomacy largely came before militarism. This is evidenced by the fact that U.S. had the highest number of treaties and agreements with different nations. Theses treaties helped the U.S. in so many ways in its quest to be a superpower; it increased the market for Americas goods and services.
Given its strong economic status, the U.S. gave out loans to nations like Germany and Japan which were reeling from devastation effects of the World War II. Since the U.S. promised to defend its allies, it won admiration leading to a strong relationship between them. The far reaching and stretched American empire had to be protected at all costs. This explains why America had so many military bases across the world.
Arguably, change of Americas policy from isolationist prevented the outbreak of third world war. This was through active participation in the North Atlantic Treaty Organization (NATO) and the United Nations (UN). While the North Atlantic Treaty Organization suppressed war outbreaks through militarism, the United Nations largely used diplomacy among member states.
For the United Nations, diplomacy was the preferred conflict resolution tool but militarism was a measure of last resort. In spite of this, Americas steady growth to becoming a superpower, competition emerged from the communist Union of Soviet Socialist Republics (USSR). Ideological differences saw the two superpowers take contrasting paths on most issues.
The 1950s saw the beginning of decolonization in Africa. The two got embroiled in a fight to spread their ideologies among the newly-independent African countries. This shows how much interested the U.S. was in African countries given the fact it is a continent with minerals and resources.
International politics and issues are dynamic. Americas foreign policy has to an extent also evolved to adapt to changes. Americas interventionist approach has won America Co-operation with other nations. For instance, Myanmar has benefitted from Americas interventionist policy. Today, it is on the path to democracy as compared to when it was under dictatorship before the U.S. intervened. The U.S. national interests and goals have also been under great scrutiny even by the U.S. citizens themselves.
They fear their countrys over reliance on external oil. What happens if our relationship with these nations becomes strained? Such are the worries the U.S. has to an extent it does not want re-establishment and re-allocation of international responsibilities.
In conclusion, the U.S. national interests and goals articulated after the World War II. First, they ensured that they obtained peace with majority of nations to act as a gateway through which they could pursue their interests and articulate their goals.
Evidence to show that the U.S. had national interests after the World War II include: they had the highest number of treaties and agreements with different nations, they fought to obtain their interests and formed international policy which won them co-operation with many nations across the world.
My countries of study are Kenya and Malaysia located in Sub-Saharan Africa and East Asia respectively.
The Progress of Kenya towards Meeting the MDGS
Kenya is one of the fastest growing developing countries in Africa. It is located along the Indian Ocean in the Eastern parts of Africa and is boarded by Somalia to the East, Tanzania to the Southern West, Uganda to the West, Southern Sudan to the Northern West and Ethiopia to the North. Its location favors its economic growth and development because its port of Mombasa serves other landlocked countries such as Uganda, Ethiopia and Southern Sudan (International Monetary Fund, 87).
The government of Kenya is opportunistic of meeting the MDGs by 2015 and strategies have been put in place to see that the country realizes them. In 2008, the government of Kenya launched a development program dubbed Kenya Vision 2030 that is based on three pillars that include economic, social, and political pillars.
The objective of the program is to help the country in realizing the vision of the country becoming a fully industrialized, middle-income economy. Implementation process of the program has been taking place for the last fours and has facilitated in the realization of MDGs.
Fully realization of the MDGs seems to be a great challenge to the government of Kenya, especially now that there is a transition to a new government that was elected on March 4, 2013. There is a high optimism due to the ongoing implementation process of the Vision 2030.
The country targets to reduce child mortality to 33 per 1000 live births by 2015 from initial 111.1 in 2000. However, there is an alarm that the country could fail to achieve its goal after a 20% increase in child mortality recorded in 2011. The rate rose from 84.7 per 1000 live births in 2010 to 105 per 1000 live births in 2011. This inadequate performance is facilitated by poor investment in the health sector (LIGAMI, par 5).
The Progress of Malaysia towards Meeting the MDGS
Malaysia is located in the South East Asia and boarders Thailand, Brunei, and Indonesia. However, it is formed of two nearly equal lands whereby one is an island in the South China Sea that borders Singapore, Philippines and Vietnam. It is more developed than Kenya and, according to economic growth and development, it has reached to the level of a middle-income developed country. It had a GDP growth rate of 6.5% in 2011 indicating that it is yet to achieve its goal of a 10% annual GDP growth rate.
The government of Malaysia has put in place strategies that would see the country achieving the MDGs by 2015. Since the inception of the MDGs, the country focused on the implementation of strategies that would help the country to achieve high economic growth and development.
The government put effort in ensuring that the country does not rely only on the export of agricultural products as the major foreign earner but also manufactured products and oil. This has been achieved and the government introduced a policy whereby 6% of the GDP is allocated to the ministry of health. Consequently, under-5 child mortality rate has declined by two thirds since inception in 2000 and is at a stable rate of 7 per 1000 live births. Hence, Malaysia is at par with the MDGs unlike Kenya (The World Bank, par.8).
Kenya and Malaysia
Kenya has more economic challenges than Malaysia that is reflected by its slow economic growth and development. This implies that it is difficult to achieve the MDGs because all goals are capital intensive and therefore a challenge to undeveloped economy. Political environment is also a great factor that determines the ability of a country to achieve the MDGs. Malaysia has a stable political environment that attracts foreign direct investment and promotes other economic activities in the country (World Bank, par.5).
There are similarities in the implementation strategies for the MDGs in the two countries. At outset, the governments for two countries embarked on ensuring that stable economic growth rate is achieved in each country. This is because MDGs are capital intensive thus government ought to have reliable sources of money for funding the projects.
Malaysia achieved stable economic growth faster than its counterpart by strengthening manufacturing industry. However, Kenya has not achieved stable economic growth and relies heavily on agricultural products for export though it has oil that is yet to be commercialized (World Bank 76).
On the other hand, Kenya has had an unstable political environment for quite a long time and has deterred the economic growth. Unlike, Malaysia, Kenya does not have an established policy in place that allocates funds to health sector. Instead, donors contribute more funds than the government and majority of population do not have an access to improved health facilities. This implies that Kenya will not achieve the targeted MDG of reducing under-5 child mortality by two third by 2015 (World Bank 98).
Works Cited
International Monetary Fund. Kenya: Poverty Reduction Strategy Paper Progress Report. New York: International Monetary Fund, 2012.
Ligami, Christabel. Child mortality rate up by 20pc. 2011. Web.
United Nations: The Millenium Developement Goals at 2010. Kuala Lumpur: United Nations Country Team, Malaysia, 2012.
World Bank. World Development Indicators 2012. Washington D.C: World Bank Publications.
World Bank. Mortality rate, under-5 (per 1,000 live births). 2011. Web.
India has surpassed many countries in the realization of the MDGs. It is among the countries that have met a number of set targets. This essay will examine Indias achievement of the MDGs. The progress of MDG markers will be discussed in relation to the stipulated target values. The problems associated with the achievement of these goals will also be discussed and solutions to the problems.
Introduction
The millennium pronouncement, made during the United Nations assembly in the early 2000, incorporated eight aspirations commonly known as the Millennium Development Goals (MDGs (Government of India, 2013, p. 6). Eighteen objectives were set as yardsticks for measuring the eight Millennium Development Goals. Out of the eighteen objectives, twelve are applicable to India.
There are 53 markers for measuring the countrys progress towards the realization of the MDGs (UNESCAP, 2015, p. 4). While the goals are broad in nature, the objective are more particular and are described in actual terms (Government of India, 2013, p. 8).
The essay will only focus on 4 MDGs, namely: hunger and poverty alleviation, universal primary education, gender equity and women empowerment, environmental sustainability and global partnerships for development. The essay will analyze the countrys achievement of MDGs based on the updated data sets. The progress of MDG markers will be discussed in relation to the stipulated target values. The problems associated with the achievement of these goals will also be discussed and solutions to the problems.
Significance of the selected goals
The selected goals provide a blueprint for strategizing intercession programs and yardsticks to monitor progress in improving the lot of humanity and poverty alleviation. They also help in eliminating any form of deprivation and conservation of environmental resources. In addition, global partnership plays a crucial role in exchange of ideas, opening new opportunities and general economic growth.
Progress of the selected goals
The country has so far managed to reduce poverty level by half. The Poverty Head Count Ratio (PHCR) is currently at 20.74 percent against the target of 23.9 percent. Likewise, the country has managed to reduce the number of people suffering from food shortage by 50 percent.
Figure 1: Poverty Head Count Ratio in India. Source: UNESCAP (2015, p. 13).
Universal primary education has already been realized. The overall enrollment rate is about 99.89 percent. The Apparent survival Rate, which is the proportion of students who finish primary education, is around 90 percent (UNESCAP, 2015, p. 14). The country is also making great strides in eliminating gender disparity, particularly in the educational sector. Gender Parity Index in primary education has already been achieved. The proportion of women employed in the non agricultural sector is about 20 percent. This figure is expected to reach 23.1 percent by the end of the year against the target of 50 percent. Similarly, the percentage of women holding elective seats is about 12 percent against the target of 50 percent in 2015.
Figure 2: Gender Parity Index. Source: Government of India (2015, p. 16).
India has been able to integrate the values of sustainable development into its laws and programs. This is aimed at preventing the destruction of natural ecosystems. The countrys forest cover has increased by roughly 1150 sq. km. The protected areas cover about 5 percent of the total land area.
The percentage of households without access to clean water and sanitation has decreased to 17 percent against the target of 20 percent by 2015. On the other hand, the proportion of households without sanitation facility has declined to 43 percent by 2015 against the target of 5 percent (UNESCAP, 2015, p. 12).
Last but not least, Indias cooperation with global partners has vastly improved, particularly in the private sector. This has been enhanced by the information and communication technologies. Nevertheless, overall tendency, which is the number of foreign phone calls per 1000 people, has declined since 2011 after a considerable progress (UNESCAP, 2015, p. 15).
Figure 3: Overall tendency. Source: UNESCAP (2015, p. 23).
Problems associated with the realization of the selected goals
One of the greatest challenges associated with the fight against hunger is overreliance on food imports. The country still lacks self sufficiency in the production of food. Despite increasing the area under paddy rice by nearly 20 percent, the self sufficiency level is still around 68.2, which is way below the target of 70 percent.
It should be noted that rice is a staple food in India and, therefore, can be used to benchmark the aggregate food production in the country (Government of India, 2015, p. 20). The universal primary education has led to congestion in schools and shortage of teachers due to abnormal enrollment. The student to teacher ratio is way below the conventional standard. In addition, the government has been forced to borrow more funds in order to meet the selected goals. This has put the country at a huge risk (UNESCAP, 2015, p. 14).
Recommendations
The government can overcome the problem of overreliance on food imports by increasing the area under food crops, providing subsidized agricultural inputs and embracing new farming technologies. Teacher to student ratio can be enhanced by employing more teachers and building more schools. The huge amount of debts can also be avoided by setting realistic targets.
Conclusion
Self-sufficiency in food production is very important since over-reliance on food imports puts the country at a huge risk in terms of sovereignity and overdependence on other countries for key food commodities. In addition, inadequate education facilities and low teacher to student ratio can compromise the quality of education. Therefore, they are very crucial. Lastly, setting unrealistic targets can create imaginary failures, which can put a country under enormous pressure.
References
Government of India. (2013). Towards Achieving Millennium Development Goals in India. New Delhi: Ministry of Statistics and Programme Implementation.
Government of India. (2015). Millennium Development Goals: India Country Report. New Delhi: Ministry of Statistics and Programme Implementation.
UNESCAP. (2015). India and thee MDGs: Towards a Sustainable Future for ALL. New Delhi and New York: UN Publications.
The project by the UN Member States called the Millennium Development Goals (MDGs) was developed throughout the last decade of the twentieth century and lasted until 2015. It was a set of 8 goals that focused on bringing the lagging part of the world population closer to modern living standards. These goals were considered realistic in terms of achieving and were meant to reduce poverty, inequality, child mortality rates, violence, and disease mortality rates, as well as promote education, care for the environment, and partnership.
By the end of 2015, most of these goals were partially achieved in numerous countries. However, several states did not produce any meaningful results due to the lack of precise statistics. Despite this factor, most of the goals were achieved, at least partially, and the project is considered to be a success. The world experienced the most substantial decrease in poverty, mortality rates in low- and middle-income countries (LMIC), as well as the rise of democracy among underdeveloped countries.
These goals served as a foundation for the future development and sustainability of life on the planet. New goals were developed by the United Nations during the 2010s, expanding the idea behind the Millennium Development Goals. The project was named the Sustainable Development Goals (SDGs), and it serves as an expansion of previous goals and is set to be completed by the year 2030. It consists of 17 global goals with a purpose similar to previous ones, except it complements past goals and adds several new ones.
The current focus is on building a sustainable society that equally values not only the prosperity of humankind but also cares about the global environment, equity, and development of the planet as a whole. The project expands the idea of raising the living standards of people by aiming to provide more significant opportunities for each individual and increase global productivity. The support for LMICs is still considered as one of the main goals, but the planet itself is also a target of global development. These goals are supposed to save the momentum of MDGs and use them as a starting point for faster evolution. They acknowledge the interconnectedness of the problems, as countries study and work on them simultaneously. This approach brought some criticism due to overcomplicated design about the simplicity of MDGs, some goals are even considered counteractive to others, yet they are all deemed necessary.
These issues are explainable by progressing views on the world and the conscious behavior of humanity, which became a necessity for the survival of civilization. Unlike MDGs, SDGs promote innovation and partnership, taking into account political issues. They encourage innovation and collaboration, a self-conscious approach to human behavior, and strive to make life affordable to everyone. The project includes a higher number of environment-focused initiatives, as human survival is linked to the preservation of the biosphere.
In conclusion, the completion of this project is necessary for humanity to survive and preserve the planet and life on it. The establishment of world peace, eradication of poverty, inequalities, hunger, and other issues is not a moral decision, but a rational one. This transformation will enable the planet and all of its species to co-exist and evolve in a non-harmful way.
Friendship, hatred, fear, and social organization issues are the ideas that run through the novel Lord of the Flies. A catastrophe resulting from which a group of boys, without any adults, ends up on a desert island has two potential scenarios. The first defines teenagers behavior as remaining human and decent. The second is that the boys eliminate the burden of civilization, which forces them to run wild, forgetting about values and discipline. The storys main idea is that the extreme conditions in which the boys occurred showed their actual life goals and values.
Jack is the head of the church choir, but his faith is feigned, false, as evidenced by his other behavior. He and his ensemble, dressed in majestic black cloaks, are symbolically represented by the elite. The island exposed the evil that hides in each of the boys, and that same Beast broke out. Ralph is the personification of order, holding on to civilization. Like Piggy, he spent the entire time on the island in old clothes, even though they were all torn on him (Golding 26). It is another detail that distinguishes them from the hunters. However, in the book, Ralphs human personality is tested for strength: fighting savages for his life, he forgets about the human in himself, becoming like the rest. The child of science in Lord of the Flies is Piggy. This boy is short-sighted because he looks only at science and does not believe in monsters from a scientific point of view, but he firmly believes in civilization (Golding 30). In other words, the characters personalities and their lives before the incident on the island affected their behavior and defined their goals and role distribution.
Therefore, the goal of Ralph was to stay true to humanity and not succumb to violence. At the same time, Jack and his followers obeyed the evil before and during the event. They behave according to their ideals and goals. Such a plot shows that the behavioral reaction of people to particular events (both regular and extreme) depends on their character traits and the strength of their personalities.
One of the goals to increase medication safety as established through the National Patient Safety Goals (NPSGs) requires that the drugs and other solutions are appropriately labeled in the perioperative area and during other procedures. This safety goal enables healthcare providers to eliminate various issues that may arise when managing patients. This paper seeks to review the NPSGs goal and evaluate its implications for nursing practice.
Review of Importance of Labelling Medications and Solutions
Labeling medication and solutions in the perioperative areas and during procedures is central to the maintenance of sterility. For example, the omission of medication due to lack of labeling could lead to re-dosing or the use of the wrong drug hence leading to the development of an infection on the surgical site (Brown, 2014). The requirement reduces the risk of the staff using the wrong solutions or medication because of changes in containers.
The medication safety goal serves to eliminate unnecessary risks such as the development of allergic reactions because of using the wrong medication or solution during the procedure (Cohen & Smetzer, 2015). For example, before the patient undergoes a surgical operation they are evaluated to determine for any predisposition to develop allergic reactions resulting from penicillin or even other medications such as cefazolin (Cohen & Smetzer, 2016). Therefore, failure to label medication in the perioperative area could lead to the use of the allergens on patients who have a risk of developing an allergic reaction hence potentiating the development of an anaphylactic reaction.
The regulation on labeling medication as per the NPSGs helps to reduce the risk of delaying the provision of medication to patients. For example, the delay in administering ephedrine when managing hypotension could result in organ hypoperfusion among the patients undergoing the procedures (Nanji, Patel, Shaikh, Seger, & Bates, 2016).
Impact for Nursing Practice
The goal to label all medications in the perioperative area and during producers has a direct impact on the nursing practice. For example, the nurses role in the perioperative environment will include verification of medication and solutions in the different containers in the field (Treiber & Jones, 2012). Nurses are required to document the different agents used to prepare medications and solutions as well as provide labeling information that will help in identifying the expiry dates. Based on the new goal of patient safety, the nurses should ensure that they discard the different medications and solutions that are not appropriately labeled during the surgical procedures to avert the potential harm that could affect the patients (Stratman & Wall, 2013). Thus, due to this new patient safety goal, the nurses bear increased responsibility for ensuring that patient safety is a priority within the perioperative environment and during the procedures.
Conclusion
The goal to label all drugs and solutions that are available within the perioperative environment and during various procedures when managing patients helps to address fundamental issues that may pose risks to patients. The patient safety goal helps to prevent the administration of the wrong medication to the patients, delays in providing the required drugs, and contamination of the surgical sites which could lead to infection. By observing the patient safety recommendation, the healthcare providers can also prevent the occurrence of allergic reactions that could be potentiated by the use of the wrong medication or solution. The patient safety goal makes nurses a central part of the healthcare team as they should play a role in preventing any harm from occurring to the patient by ensuring all the drugs and solutions used are labeled while also discarding those that have no labels.
References
Brown, L. B. (2014). Medication administration in the operating room: new standards and recommendations. AANA Journal, 82(6), 465-469.
Cohen, M., & Smetzer, J. (2015). No Unlabeled Containers Anywhere, Ever! Where Did this come from? Hospital Pharmacy, 50(3), 185-188.
Cohen, M., & Smetzer, J. (2016). Key Vulnerabilities in the Surgical Environment: Container mix-ups and syringe swaps; Do not confuse Idarucizumab with Idarubicin. Hospital Pharmacy, 51(3), 199-203.
Nanji, K. C., Patel, A., Shaikh, S., Seger, D. L., & Bates, D. W. (2016). Evaluation of perioperative medication errors and adverse drug events. The Journal of the American Society of Anesthesiologists, 124(1), 25-34.
Stratman, R. C., & Wall, M. H. (2013). Implementation of a comprehensive drug safety program in the perioperative setting. International Anesthesiology Clinics, 51(1), 13-30.
Treiber, L. A., & Jones, J. H. (2012). Medication errors, routines, and differences between perioperative and non-perioperative nurses. AORN Journal, 96(3), 285-294.
Ensuring effective communication between care providers is essential to preserving patient safety and achieving better treatment outcomes. In the contemporary healthcare context, teams are interprofessional, meaning that care providers must promptly pass information about patients, their conditions, and diagnostic tests to prevent harm to patients and achieve treatment goals (Foronda, MacWilliams, & McArthur, 2016). Nightingale Community Hospital aims to provide patients with high-quality care and meet all the appropriate standards of patient safety. The present executive summary will seek to apply the National Patient Safety Goals to the practices of this institution to clarify its current compliance status. Then, a plan for compliance will be proposed to enhance the level of compliance and develop new practices through consistent improvement. Finally, a justification for the compliance plan will be developed based on research evidence and assessment results.
Compliance Status
The National Patient Safety Goals are a useful source of information for institutions wishing to enhance the quality of care delivered to their patient and ease the process of accreditation and certification. Nightingale Community Hospital seeks to meet all the National Patient Safety Goals to prevent harm to patients and ensure that care providers adhere to best practice recommendations in terms of patient safety. Nevertheless, there were some gaps identified as part of the assessment, which means that the current compliance status of the institution is not ideal.
First, the recommended time of reporting critical results of diagnostic tests has not been achieved consistently over the year. Although the rate of 60-minute reporting has increased from 63 percent in January to 80 percent in December, there are still gaps that must be addressed to meet the NPSG for Communication. Secondly, the NPSG recommends developing written procedures for managing critical results that include definitions, reporting chains, and time limits. However, there is no evidence of these written procedures in the Nightingale Community Hospital. The two documents provided for review concern specific manipulations, such as site identification and verification and pre-procedure handoff, but a particular policy for managing critical results of diagnostic tests is absent. Thirdly, based on past survey results, the Hospital also requires improvements to prevent the use of unacceptable abbreviations. These could be supported by the development of written reporting procedures and thus also apply to communication compliance.
Overall, the Hospital is only partly compliant with National Patient Safety Goal 2, Improve the effectiveness of communication among caregivers. This is evident from the lack of procedures for managing critical results of tests and diagnostic procedures, which means that the Hospital does not meet EP 1. Without written procedures, their consistent implementation throughout the institution is not possible, and thus, EP 2 is also not met. However, EP 3 is met since the organization tracks compliance with reporting standards and provides data on the hospital-wide rate of compliance. The following are the thirteen EPs for communication that are listed as compliant and non-compliant.
The presence of pre-procedure preparations to confirm that the correct procedure is applied for a relevant patient at the correct site. COMPLIANT
The identification of the items that should be available to perform procedures and the application of a standardized list to confirm their presence. The following items are not included: relevant documents, some tests are not labeled, and standardized lists are not available for every patient. COMPLIANT
Marking the items that should be available to patients in the procedure area. NON-COMPLIANT.
The identification of procedures that clarify the details of marking the incision insertion site. At least the sites should be marked if more than one location is possible for the procedure. The other requirement for marking is if the selection of another site would reduce the quality or safety of the procedure. COMPLIANT
It is important to note the procedure site before the procedure, the patient involvement is encouraged if it is possible. COMPLIANT
A licensed independent practitioner is responsible for marking the site. This practitioner should be present when the procedure is performed to ensure safety. The imperfect environment is the condition that allows the practitioner to delegate site marking to an eligible individual. The latter should be approved by the organization and has qualifications: a medical postgraduate program and licensure. NON-COMPLIANT
The site marking method and type are explicit and are consistent across the Hospital. COMPLIANT.
Those patients who refuse site marking can have an alternative, written process.
If it is technically or anatomically impossible or unreasonable to mark the site, such as mucosal surfaces or perineum, an alternative process should be in place. COMPLIANT
A time-out should be made immediately before performing the incision or beginning the invasive procedure. COMPLIANT
The time-out is standardized, includes the team members who would perform the procedure, and is conducted by the designated member of the team. NON-COMPLIANT
When two or more procedures are being performed on the same patient, and the person performing the procedure changes, perform a time-out before each procedure is initiated. NON-COMPLIANT
During the time-out, the team members are expected to have an agreement on the correct site, the procedure to be performed, and the correct patient identity. COMPLIANT
Documenting the time-out completion. COMPLIANT
Plan for Compliance
Since marking the items in the procedure area, the responsibility of licensed independent practitioners and time-out standardization are the main non-compliance points for the given organization. It is important to start the corrective plan with a detailed assessment of the reasons. In particular, the responsible person should be assigned the task of collecting relevant information and disseminating it to the hospital leadership. After the clarification of the reasons for non-compliance, the Hospitals management should prepare a meeting to discuss these points with practitioners and identify the ways for addressing the challenges. Such a cooperative approach to resolving these problems is likely to lead to the greater involvement of care providers in their work, as well as more effective and open relationships among colleagues.
To achieve the goal of improving the coherent work of care providers and meeting the NPSG for communication, it is necessary for the Nightingale Community Hospital to make improvements. The first suggested step is to develop a policy for imperfect environments that require the assistance of another professional through delegation. Within 30 days, the Hospital should provide a detailed plan of action and requirements to choose and assign a practitioner, ensuring that he/she has licensure and a medical postgraduate program. These should be discussed and listed in a separate protocol that would include definitions, indicate the reporting chain to be implemented, and set the standard time limits to promote reporting within 60 minutes from when the results become available. This protocol should be developed by the Director of Patient Safety in line with the recommendations provided by the Joint Commission. The staff should receive information about the updates, as well as education and training necessary for them to ensure compliance within 30 days.
The second step of the plan is to enhance the monitoring of reporting times to ensure that the data are collected for each shift within 30 days. This will help to determine whether there are any individual care providers who might need additional training in reporting. By identifying the results for each shift and reviewing them weekly over 30 days, the Director will gain more insight into the situation and will thus be able to develop the controls necessary for further improvements. Accordingly, the Hospital would time-out standardization compliance through the proper and timely reporting and monitoring.
Third, it is recommended that the Hospital develops an additional policy for care provider communication that would improve marking the items that should be available to patients in the procedure area. This will help to establish the main principles of communication in the procedure area and promote overall compliance among care providers. For instance, the protocol could target the use of verbal orders or readbacks and clarify unacceptable abbreviations. These standards would assist care providers in enhancing their general communication practices, thus contributing to patient safety and service quality within 30 days.
Justification
The justification for the proposed compliance plan lies in scholarly research on the topic of care provider communication, as well as on the assessment using the NPSG. On the one hand, research suggests that effective communication between care providers is essential to patient safety. For example, Gluyas (2015) states that prompt and efficient communication is vital to cooperation, which, in turn, contributes to the prevention of medical errors and other negative consequences. Additionally, enhanced communication between care providers can contribute to patient satisfaction (Burgener, 2020). By increasing patient satisfaction, the Hospital can achieve better performance and attract new clients, thus enhancing profitability.
On the other hand, the proposed action plan will help to address the gaps in compliance identified in the assessment. Improving diagnostic test result reporting is essential for adhering to the NPSG since it is among the core goals in the Communication domain. This is because prompt diagnostic test reporting helps to prevent diagnostic errors and improve patient safety outcomes Gleason et al., 2017). Similarly, promoting the practices that enhance communication, in general, will help to ensure smooth cooperation between members of interprofessional teams as required by the NPSG. Besides identifying areas for improvement, the NPSG can also be used for goal setting, especially given the fact that the organization seeks to achieve a higher level of compliance. In this way, the recommendation to update goals for review in the Communication domain is also justified based on the results of the evaluation.
Conclusion
Overall, the summary highlights the importance of adhering to the NPSG communication standards and goals. Effective communication between care providers is necessary to enhance patient safety and outcomes. It can also help to prevent critical medical errors that stem from delays in communicating diagnostic or other medical information pertaining to patient cases. However, the assessment revealed that there are some gaps in the application of the NPSG by the Nightingale Community Hospital. More specifically, the organization must improve the reporting of diagnostic test results, limit the use of unacceptable abbreviations, and set new goals to ensure compliance with the NPSG. To address these gaps, the organization should develop additional practice protocols, add monitoring mechanisms, and update its goals for review. Implementing the proposed action plan will support the Hospital in complying with the NPSG and enhancing patient safety indicators.
References
Burgener, A. M. (2020). Enhancing communication to improve patient safety and to increase patient satisfaction. The Health Care Manager, 39(3), 128-132.
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36-40.
Gleason, K. T., Davidson, P. M., Tanner, E. K., Baptiste, D., Rushton, C., Day, J.,& & Newman-Toker, D. E. (2017). Defining the critical role of nurses in diagnostic error prevention: A conceptual framework and a call to action. Diagnosis, 4(4), 201-210.
Gluyas, H. (2015). Effective communication and teamwork promote patient safety. Nursing Standard (2014+), 29(49), 50-56.
Patients at any point need an advanced care and proper safety at all times. According to the Joint Commission, hospitals should focus on seven patient safety goals for 2021 (Clarkson, 2021). The organization uses new evidence on emerging patient safety issues to inform its goals for the coming year. This data inspires other Joint Commission Center for Transforming Healthcare initiatives and teaching materials. Listed below are some of the hospitals goals and how they align. When delivering care, treatment, and services, make sure to use at least two methods of identifying the patient. Misdiagnosis and mistreatment of patients can occur at any stage of the process.
First, the person for whom the service or treatment is intended must be reliably recognized. A persons name, a government-issued ID number, a phone number, or other unique identifier is permitted. Unable to speak, babies have fewer identifying characteristics (Clarkson, 2021). Misidentification led to serving a mothers breastmilk to the wrong newborn, posing a danger of transmitting bodily fluids and possible diseases to the newborn. In this case, all providers must use the same identifying scheme.
In perioperative and other procedural settings, mark all medications, medication containers, and other solutions entering or leaving the sterile field. A syringe is a medication container, while medicine cups and basins are others. Unlabeled containers of medications or other solutions make it impossible to track down the contents. Mistakes occur when drugs and other solutions have been transferred from their original containers to unmarked containers, some of which have been catastrophic. Despite the dangers of this approach, it is a commonplace in many businesses and organizations. Safe medication management requires the labeling of all medications and the containers in which they are stored. This procedure tackles a well-known risk factor in the delivery of drugs in perioperative and other procedural settings.
Reduce the risk of anticoagulant therapy-related harm to patients. Prophylactic anticoagulation for preventing venous thromboembolism in regular settings does not meet these criteria (for example, related to procedures or hospitalization) (Clarkson 2021). Anticoagulation is used to treat several conditions, but the most prevalent include atrial fibrillation, DVT, PE, and mechanical heart valve implant. Complications in administration, monitoring, and patient compliance make anticoagulants more harmful than other drugs. This National Patient Safety Goal may also improve the safety of patients taking this class of medications.
Moreover, to improve patient outcomes, anticoagulation therapy must involve patient education. Patients must obtain anticoagulant education from a medical professional who understands the risks of the medication and how to prevent them (Saptarini, Sujianto, & Nurjazuli, 2021). Warfarin and direct oral anticoagulants are less likely to cause adverse pharmacological events when used as established anticoagulation therapy protocols that involve patient participation. Maintain and convey patient medication information clearly and consistently. There is evidence to suggest that patients results can be affected by medication inconsistencies. Reconciliation is a procedure of comparing a patients current prescriptions to the new ones that have been prescribed to ensure that there are no differences. The comparison considers the requirement to continue current prescriptions and the potential for duplications, omissions, and interactions. Reconciling pharmaceutical information includes the name of the medicine, dosage, frequency of use, route, and purpose. To ensure the safe prescribing of pharmaceuticals in the future, organizations must identify the data they need to collect and use that data.
References
Saptarini, S. D., Sujianto, U., & Nurjazuli, N. (2021). Patient safety round to improve patient safety goals in hospital inpatient units. Public Health Perspective Journal, 6(2).
Clarkson, K., (2021). National patient safety goals effective January 2021 for the hospital program. Joint Commission.
A medical interview is one of the significant components in establishing a trust distance, identifying complaints, assessing the internal picture of a patients illness, discussing possible options for a treatment model, and several other critical aspects. An interview with a patient is one of the most effective assessment tools in clinical practice (Slade & Sergent, 2022). Hence, a thorough assessment of the principles of this procedures organization is required to understand its essence and specifics. A comprehensive analysis of the process for obtaining information about a patient through several methods, tactics, and strategies is what the emphasis is on in this paper.
The Goals of a Patient Interview
Obtaining comprehensive information about a patient to provide adequate care, developing a therapeutic relationship between a patient and a medic, as well as making a diagnosis are the main goals of an interview. The information obtained through this strategy will be a basis for future comparison and annual updates as needed (Myrick et al., 2019). In this case, an interview should be considered more as a way to establish a good relationship with a patient in terms of the realization of empathy and reassurance (Slade & Sergent, 2022). In general, an interviewers fundamental goal is to find causes and potential solutions for an individual.
Components of the Patient History
There are several critical components of the patient history: chief complaint (CC), history of present illness (HPI), review of systems (ROS), and past, family, and social history (PFSH). First, a chief complaint (CC) is a brief statement that most fully describes the cause of the encounter. Second, a history of present illness (HPI) tells the development of a specific patients disease. Third, a review of systems (ROS) means an inventory of the bodys systems obtained through a series of questions to identify signs and symptoms that a patient may be experiencing. Fourth, past, family, and social history (PFSH) is a resume of the areas of history directly related to concerns identified in the HPI.
An Incident
Using the wrong, incorrectly sized cuff is a case where I used the improper technique for measuring blood pressure. Moreover, I assumed that patients could sit or lie with their arms hanging by their sides. Based on this incident, I learned that too large or too small a cuff could give deliberately false results and low or high readings that may not correspond to reality.
A Barrier
The language barrier was one of the cases when I had to evaluate a patient from another culture. This man spoke little English, and we could hardly understand each other. However, this is nothing unique or unusual since the medical worker still addresses a patient, for example, through an online translator (Myrick et al., 2019). Thus, we succeeded in communication with the help of facial expressions, gestures, and modern technologies.
Conclusion
Summarizing the above-mentioned, it is necessary to state that interaction with the patient through interviews is essential for implementing high-quality and correct care and treatment. The interview aims to establish a trusting relationship with the patient and identify the information required for making a diagnosis. Of course, there are various difficulties in interacting with patients. For example, an incorrect measurement of blood pressure or a language barrier should be highlighted in such moments. However, they can be minimized and ultimately eliminated with a competent and correct approach.
Maintaining a sustainable environment is vital for allocating and achieving sustainable development goals (SDGs). SDGs are vital. The United Arab Emirates has significantly contributed to the SDGs accomplishment to preserve the environment and balance the social and economic factors (Fukudaa and Ouchidab, 2020). It signifies that the goals should be integrated in order to achieve equilibrium in society and transform it for better living on the planet.
Similar to other countries, the UAE is highly exposed to climate change, including damages from sea-level rise, weather events, and others; thus, the government placed this issue at the top of its priorities. UAE is increasingly concerned with climate change as it is at risk of facing severe droughts, warmer temperatures, and flood (Fukudaa and Ouchidab, 2020). As a result, the state decided to address this problem by actively participating in Vision programs aimed at achieving SDGs.
Due to the issues increased alertness, the country reacted quickly to implement changes to improve the situation. Primarily, the UAE gave a new title to the Ministry of Environment and Water. Now it is named the Ministry of Climate Change and Environment so that it deals more with the global warming problems (Vu, 2017).
Second, UAE established a program according to which the clean energy sources will be used to generate at least 24% of energy. Moreover, the state council decided to ally with the private sector to conduct research related to energy preservation. At the global level, the country partnered with the U.S. to launch initiatives to save the global energy market.
In addition, the UAE decided to draw the publics attention to notify them and urge them to participate in achieving this SDG. As a part of this venture, the government held awareness campaigns to promote conscious behavioral patterns in order to conserve the environment and its natural resources. In May 2014, they hosted an event for the members of the government, the private sector, and other stakeholders (Fukudaa and Ouchidab, 2020). The gatherings objective was to create a sense of awareness and urge the participants to take actions for fighting climate change.
Another step towards achieving the goal related to climate change was launching environmental education programs, which have become one of the most eminent sustainable development constituents. The primary objective of this initiative was the inclusion of environmental-related content into the school curricula. Moreover, the UAE created the Our Generation plan in 2016 to advance school programs aiming to focus more on environmental awareness (Vu, 2017).
This idea was supposed to encourage students to take part in ecological harm reduction events. As a result of these modules, sustainable schools emerged to introduce more extended programs related to climate change, and new green curricula were introduced to the children. What is more, conferences concerning sustainable development goals were held throughout the last five years in order to negotiate and highlight how the UAE can fight climate change.
Most notably, the UAE became one of the states which validated the Paris Agreement. The ratification took place in September 2015, and the agreement was presumed to raise the usage of energy and water preservation measures. Moreover, they started to control gas emissions and invested billions of dollars in the decarbonization to establish a green transition. It was identified that the state reduced gas utilization by 78% since 1995 (Vu, 2017). The technologies implemented are still being advanced in order to use more natural resources as energy drivers, which can mitigate the impacts of global warming and create a safe environment for the population.
To conclude, it seems essential to state that the UAE has significantly contributed to SDGs development and achievement. One of the prioritized SDGs is climate change, which poses a potential threat on the local, regional, state, and global levels. Therefore, the country made multiple attempts to prevent global warming and raise environmental awareness. Creating educational programs, gas emissions, energy, and water conservation initiatives has become part of the plan. All in all, these programs have incredibly helped the government to motivate society to fight the common enemy.
Reference List
Fukudaa, K. and Ouchidab, Y. (2020) Corporate social responsibility (CSR) and the environment: does CSR increase emissions?, Energy Economics, 92, pp. 1-10. Web.
Vu, N.A. (2017) Grassroots Environmental activism in an authoritarian context: the trees movement in Vietnam, Voluntas, 28, pp. 11801208. Web.