Get college assignment help at Smashing Essays You are a manager of a clinical team and one of your supervisors arrives to work daily at 10:00 am but signs in at 9:00 am. At the end of each week you must sign off on his/her timesheet.Write a disciplinary action plan that addresses the issue. Detail how you will confront the employee. Will you involve any other employees or managers? What are the ethical ramifications if this behavior is not addressed?

help on Intro to Human Services discussion post

Choose a country, other than the one you currently live in, to represent and explain some of your responsibilities as a helping professional in that country. How do you work with people from other cultures and how can you improve your skills?

VoIP / G-Suite ProjectUniversity A and University B have closed on their

VoIP / G-Suite ProjectUniversity A and University B have closed on their merger. Per the merger, you have been hired as the Project Manager overseeing the deployment of a new VoIP phone system for the combined University and deployment of Google G-Suite to replace the University’s use of MS Office. Also, all of the school’s cell phones will be exchanged for the latest Google smartphone and the service provider will be Verizon Wireless.The combined University comprises fifty (50) campus locations and two (2) headquarters buildings. The combined university has over 10,000 employees serving over 100,000 students. The CIO is pressured to complete this project as soon as possible so that the combined universities can terminate their expensive license agreements with Microsoft. Note:All project submissions are submitted to Safe Assign for originality review.Write a four to six (4-6) page paper in which you define the scope of your project. In your paper you must:

VoIP / G-Suite ProjectUniversity A and University B have closed on their

VoIP / G-Suite ProjectUniversity A and University B have closed on their merger. Per the merger, you have been hired as the Project Manager overseeing the deployment of a new VoIP phone system for the combined University and deployment of Google G-Suite to replace the University’s use of MS Office. Also, all of the school’s cell phones will be exchanged for the latest Google smartphone and the service provider will be Verizon Wireless.The combined University comprises fifty (50) campus locations and two (2) headquarters buildings. The combined university has over 10,000 employees serving over 100,000 students. The CIO is pressured to complete this project as soon as possible so that the combined universities can terminate their expensive license agreements with Microsoft. Note:All project submissions are submitted to Safe Assign for originality review.Write a four to six (4-6) page paper in which you define the scope of your project. In your paper you must:

Using proper APA formatting write a 400-word discussion paper describing:Length: 2-3 paragraphs

Using proper APA formatting write a 400-word discussion paper describing:Length: 2-3 paragraphs

Read Chapter 28 mini-case study. The case is about BSC and its

Read Chapter 28 mini-case study. The case is about BSC and its efforts to implement an ERM function. From reading the case study what are the quick wins that you see? And what are the issues that will pose a challenge in creating BSC ERM program? How would you tackle the challenges?Read Chapter 29 mini-case study. This case is about Akawini Copper and United Minerals and it brings up many important concepts with ERM, such as due diligence and its role in an acquisition of an organization. How would you approach the acquisition? What changes would you implement first in the transformation process?Provide a minimum of 3 referencesAPA format(References and citations)

courses that i took for summer semester are:Access Control (ISOL-531-04) InfoTech Import

courses that i took for summer semester are:Access Control (ISOL-531-04) InfoTech Import in Strat Plan (ITS-831-40) i work as a sr. systems analyst.

Project: Applying Trauma-Informed Principles to a Social Work Practice Setting With Children and Families

Trauma-informed practice goes beyond the skills and techniques used by an individual social worker. Organizations and communities can unintentionally retraumatize clients through their policies and procedures. Social workers have a responsibility to advocate for change.In this Assignment, you use the knowledge you have gained about trauma-informed practice to evaluate the organizational and operational structure of a setting with which you are familiar. You also make recommendations for changes needed to apply core trauma-informed principles.The AssignmentIn Week 4, you explored the concept of trauma-informed services through six principles and 10 implementation domains (SAMHSA, 2014). Now, choose a setting in which you have worked providing social work services (e.g., current/previous field placement, employer, etc.) and explore the principles and implementation domains of trauma-informed services in the setting you have chosen.Submit a 5- to 7-page paper in which you address the following four areas:******Any setting you chose is fine but i currently work for our public schools as a social worker in a very rural area. our primary goal is not to serve trauma survivors but we have therapists housed in our schools who can offer services to increase the students educational possibilities.SIX KEY PRINCIPLES OF A TRAUMAINFORMED APPROACH A trauma-informed approach reflects adherence to six key principles rather than a prescribed set of practices or procedures. These principles may be generalizable across multiple types of settings, although terminology and application may be setting- or sector-specific. SIX KEY PRINCIPLES OF A TRAUMA-INFORMED APPROACH 1. Safety 2. Trustworthiness and Transparency 3. Peer Support 4. Collaboration and Mutuality 5. Empowerment, Voice and Choice 6. Cultural, Historical, and Gender Issues From SAMHSA’s perspective, it is critical to promote the linkage to recovery and resilience for those individuals and families impacted by trauma. Consistent with SAMHSA’s definition of recovery, services and supports that are trauma-informed build on the best evidence available and consumer and family engagement, empowerment, and collaboration. page 11 The six key principles fundamental to a trauma-informed approach include:24,36 1. Safety: Throughout the organization, staff and the 5. Empowerment, Voice and Choice: Throughout people they serve, whether children or adults, feel the organization and among the clients served, physically and psychologically safe; the physical individuals’ strengths and experiences are setting is safe and interpersonal interactions recognized and built upon. The organization promote a sense of safety. Understanding safety as fosters a belief in the primacy of the people served, defined by those served is a high priority. in resilience, and in the ability of individuals, organizations, and communities to heal and promote recovery from trauma. The organization 2. Trustworthiness and Transparency: understands that the experience of trauma may Organizational operations and decisions are be a unifying aspect in the lives of those who run conducted with transparency with the goal of the organization, who provide the services, and/ building and maintaining trust with clients and family or who come to the organization for assistance members, among staff, and others involved in the and support. As such, operations, workforce organization. development and services are organized to foster empowerment for staff and clients alike. 3. Peer Support: Peer support and mutual self-help Organizations understand the importance of power are key vehicles for establishing safety and hope, differentials and ways in which clients, historically, building trust, enhancing collaboration, and utilizing have been diminished in voice and choice and their stories and lived experience to promote are often recipients of coercive treatment. Clients recovery and healing. The term “Peers” refers to are supported in shared decision-making, choice, individuals with lived experiences of trauma, or in and goal setting to determine the plan of action the case of children this may be family members of they need to heal and move forward. They are children who have experienced traumatic events supported in cultivating self-advocacy skills. Staff and are key caregivers in their recovery. Peers have are facilitators of recovery rather than controllers also been referred to as “trauma survivors.” of recovery.34 Staff are empowered to do their work as well as possible by adequate organizational support. This is a parallel process as staff need to 4. Collaboration and Mutuality: Importance is feel safe, as much as people receiving services. placed on partnering and the leveling of power differences between staff and clients and among organizational staff from clerical and housekeeping 6. Cultural, Historical, and Gender Issues: personnel, to professional staff to administrators, The organization actively moves past cultural demonstrating that healing happens in relationships stereotypes and biases (e.g. based on race, and in the meaningful sharing of power and ethnicity, sexual orientation, age, religion, genderdecision-making. The organization recognizes that identity, geography, etc.); offers, access to gender everyone has a role to play in a trauma-informed responsive services; leverages the healing value approach. As one expert stated: “one does not have of traditional cultural connections; incorporates to be a therapist to be therapeutic.”12 policies, protocols, and processes that are responsive to the racial, ethnic and cultural needs of individuals served; and recognizes and addresses historical trauma.TEN IMPLEMENTATION DOMAINS 1. Governance and Leadership 2. Policy 3. Physical Environment 4. Engagement and Involvement 5. Cross Sector Collaboration 6. Screening, Assessment, Treatment Services 7. Training and Workforce Development 8. Progress Monitoring and Quality Assurance 9. Financing 10. Evaluation page 13 GOVERNANCE AND LEADERSHIP: The leadership CROSS SECTOR COLLABORATION: Collaboration and governance of the organization support and invest across sectors is built on a shared understanding of in implementing and sustaining a trauma-informed trauma and principles of a trauma-informed approach. approach; there is an identified point of responsibility While a trauma focus may not be the stated mission of within the organization to lead and oversee this work; various service sectors, understanding how awareness and there is inclusion of the peer voice. A champion of trauma can help or hinder achievement of an of this approach is often needed to initiate a system organization’s mission is a critical aspect of building change process. collaborations. People with significant trauma histories often present with a complexity of needs, crossing POLICY: There are written policies and protocols various service sectors. Even if a mental health establishing a trauma-informed approach as clinician is trauma-informed, a referral to a traumaan essential part of the organizational mission. insensitive program could then undermine the Organizational procedures and cross agency progress of the individual. protocols, including working with community-based agencies, reflect trauma-informed principles. This SCREENING, ASSESSMENT, AND TREATMENT approach must be “hard-wired” into practices and SERVICES: Practitioners use and are trained in procedures of the organization, not solely relying interventions based on the best available empirical on training workshops or a well-intentioned leader. evidence and science, are culturally appropriate, and reflect principles of a trauma-informed approach. PHYSICAL ENVIRONMENT OF THE Trauma screening and assessment are an essential ORGANIZATION: The organization ensures that the part of the work. Trauma-specific interventions are physical environment promotes a sense of safety acceptable, effective, and available for individuals and collaboration. Staff working in the organization and families seeking services. When trauma-specific and individuals being served must experience the services are not available within the organization, setting as safe, inviting, and not a risk to their physical there is a trusted, effective referral system in place or psychological safety. The physical setting also that facilitates connecting individuals with appropriate supports the collaborative aspect of a trauma informed trauma treatment. approach through openness, transparency, and shared spaces. TRAINING AND WORKFORCE DEVELOPMENT: On-going training on trauma and peer-support are ENGAGEMENT AND INVOLVEMENT OF PEOPLE essential. The organization’s human resource system IN RECOVERY, TRAUMA SURVIVORS, PEOPLE incorporates trauma-informed principles in hiring, RECEIVING SERVICES, AND FAMILY MEMBERS supervision, staff evaluation; procedures are in place RECEIVING SERVICES: These groups have to support staff with trauma histories and/or those significant involvement, voice, and meaningful experiencing significant secondary traumatic stress choice at all levels and in all areas of organizational or vicarious trauma, resulting from exposure to and functioning (e.g., program design, implementation, working with individuals with complex trauma. service delivery, quality assurance, cultural competence, access to trauma-informed peer PROGRESS MONITORING AND QUALITY support, workforce development, and evaluation.) ASSURANCE: There is ongoing assessment, This is a key value and aspect of a trauma-informed tracking, and monitoring of trauma-informed principles approach that differentiates it from the usual and effective use of evidence-based trauma specific approaches to services and care. screening, assessments and treatment. page 14 FINANCING: Financing structures are designed to key principles of a trauma-informed approach. Many support a trauma-informed approach which includes of these questions and concepts were adapted from resources for: staff training on trauma, key principles the work of Fallot and Harris, Henry, Black-Pond, of a trauma-informed approach; development of Richardson,

Security Strategies in Windows Platforms and Applications(Any one have this book)?You are

Security Strategies in Windows Platforms and Applications(Any one have this book)?You are devising a network security plan for the company. Pick only two (2) of the Microsoft Windows network security best practices on page 215 in the text and discuss how you can apply them in your job. Why did you choose them and how can they better protect your Windows 2012 R2 Server? What others can you think of? If you are not working, think of your ideal job and apply the same requirements. Post your response to this forum by Thursday. Add at least one (1) reference properly formatted in APA style and cited where used. Also post a reply to at least two (2) other person’s post by Sunday.

How does the Internet of Things (IoT) affect the way you live?

How does the Internet of Things (IoT) affect the way you live? Discuss a specific example. Answer in couple sentences

Question 1Demographic Influences – List 6 demographic influences [hint chapter 6] Question

Get college assignment help at Smashing Essays Question 1Demographic Influences – List 6 demographic influences [hint chapter 6] Question 2The Final Document – September 17, 1787, the Constitution was approved and the Constitution that was to be ratified established the following fundamental principles. List the 5 principles as stated by the text book. Please make it a habit of writing the entire phrase and not what you think is important. Number your responses 1 through 5Question 3Madisonian Model – A structure of government proposed by James Madison in which the powers of the government are separated into three branches; executive, legislature and judicial.List the 3 functions of the Madisonian Model and provide 2 examples of the theory of checks and balances between the 3 branches of government. Number your responses 1 through 5Question 4Define symbolic speech from the book and give 2 examples of symbolic speechSymbolic Speech –Example 1-Example 2-How has the court system evaluated [ruled upon] symbolic speech?Define commercial speechHow has the court system evaluated [ruled upon] commercial speech?Question 5List the Civil War Amendments [three]Describe briefly defined meaning of each. Note 2 Amendments only have 1 definition while the third Amendment has 3 definitions.Question 6List the 3 factors of political socializationQuestion 7List the 2 outcomes [court rulings] of Brown v. Board of Education TopekaList the 2 outcomes [court rulings] of Alan Bakke v. The Regents of the University of CaliforniaList the 2 outcomes [court rulings] Plessy v. FergusonList the 2 outcomes of the Sleepy Lagoon Murder CaseList the 3 outcomes [court rulings] of Mendez v. Westminster and why was this case so important in the fight to desegregate educationQuestion 8The Madison Model revisited. The third important addition to our governmental structure was he compiled the Bill of Rights from existing state constitutions. Why was this so critical in ratifying of the ConstitutionQuestion 9Inherent Powers – A special category of national powers that is not implied by the necessary and proper clause consists of what are labeled inherent powers. These powers are derived that the United States is a sovereign power among nations and must deal with these and other nations. Each nation must act in its own interest. List all 4 of the Inherent Powers and would you agree this was the basis of colonialism? Yes or NoQuestion 10List 5 social movements current or past – note these are not listed in the book[s] but I am sure you have heard them in the news or maybe been involved in one too.The definition from Chapter 7 of a Social Movement – A movement that represents the demands of large segment of the public for political, economic, or social change. This is just the definition to help you key in on the 5 examples.Economic Interest GroupsMore interest groups are formed to represent economic interest that any other set of interests. Major sectors that seek influence in Washington D.C. includeList the 3 major sectors that seek influence in Washington D.C. and give 2 each real time examples. [list their names only no description needed]Please number your response and make sure when answering the questions to get the answers from the attachments not google.

– Living in a Diverse World/ Respond to peers

Most of us have goals and dreams. You probably have a vision of what the good life would look like for you. With this in mind, do you think pluralism would help you to live in a diverse society, one in which other people’s opinions and lifestyles may clash with your pursuit of the good life? Does relativism offer a better or worse alternative? Explain your reasoning.Peer1AminaAt this point of life, dream is to complete my nursing program, and continue with my career. Which is also my goal for this year. With relativism being what is approved either by oneself, culture, or society. This can be two way, at times it can be better whereas other times, it just makes thing more difficult than it is supposed to be. For any example from the book, “honor killings”, for culture that practices, it is important to know the rule or the grounds this killing are done, this is where I believe it makes life more difficult than it should be. And at times, when in need or crisis, community and society are the ones that tend to come to your aid, especially long time neighbors, or when it tight community. Peer2Mel B.In my opinion Pluralism doesn’t force people to follow traditions and values. We live in a very diverse world where not everyone is the same. I seriously think that people being different is such a beautiful thing. I love seeing different cultures celebrate their traditions, and dress how they want. It is what makes us unique. Pluralism recognizes that you are you and I am I. It gives people the opportunity to live how they want, and to do what they want. I personally enjoy being able to do as I please and believe what I want. On the flip side of it. If all I ever knew was something else, then I probably enjoy that too. I do not think that either of them trump the other. We are equal, I don’t think there is a right or wrong way to go about this.

papers so that there will be 0% plagiarism.

As stated in the title. Paraphrase the 2 papers attached so that there is no plagiarism. The paraphrased papers need to make sense so please do not just use a synonym generator.

papers so that there will be 0% plagiarism.

As stated in the title. Paraphrase the 2 papers attached so that there is no plagiarism. The paraphrased papers need to make sense so please do not just use a synonym generator.

Please view the instructions in the picture and complete the Comouter Application

Please view the instructions in the picture and complete the Comouter Application TaskI have attached all correlating files you will need to complete the tasks

For this paper you are to select one of the following topics

For this paper you are to select one of the following topics to write about:Social Media Governance for organizations: Discuss the issues that arise for organizations and the private/personal social media accounts of their employees. Use real world examples where a personal/private social media account created backlash/problems for the organization and how they handled the situation. Discuss the legal issues that can come about with governing personal/private social media use of employees.Bring Your Own Device (BYOD) Governance for organizations: Discuss the legal and regulatory issues that come with allowing BYOD in an organization. Address the issues that has been discovered in the past by provided a real world scenario where a BYOD caused security issues. Describe best practices for an organization to take when developing BYOD policies and procedures.Cloud Computing Governance Standards

Hello, I have an assignment and really important. see list 1,2,3, the

Hello, I have an assignment and really important. see list 1,2,3, the firs list is already have three topics and I post them here, but you need to follow the instructor. for the second list the new topic which is driverless vehicles. please just make them be very clear and carefully. make sure you did the reference well. 1- For the Final Assignment, you will select three distinct topics from your concepts templates to write about in the final assignment. Your three topics will address past and present implications of your topic. An example is Uber, what are some concerns of Uber in 2019, and how did the past (taxis) have an effect on Uber’s creation or challenges or did some type of improvement or evolution occur with the advent of Uber compared to the past?2- The second portion of your paper will surround driverless vehicles. Expand this discussion to include the infrastructure necessary for driverless vehicles and any ethical or moral considerations? How would driverless school buses or garbage trucks work, or driverless fire trucks or ambulances?3- This final assignment requires research, therefore integrate in-text citations and references (research) into the topics and discussions. The minimum requirement for content is three pages with a maximum of five pages of content. Content is the body of your paper: the title page, abstract, and reference section are required, but are not considered the body of a paper.It already have three topics before when you did them which are:Concept 1. Cyber security refers to the protection data and information from access by unauthorized personal (Von Solms,

A bigger part of the debate about domestic policy has to do

A bigger part of the debate about domestic policy has to do with the role of government. Is it really government’s job to provide things like health care and food to people– even those who need it?This discussion usually shows up in two important areas– health care and housing. The dangers of having a healthcare system run by the government are outlined in a nice article on Obamacare, and the challenges with having the government step in to help people with mortgages is nicely outlined in this article on mortgages.Read these articles (skimming is OK), then post your response to these questions:

Discussion1:Review chapter 8; Do you agree or disagree with this statement and

Discussion1:Review chapter 8; Do you agree or disagree with this statement and why: the “All hate crimes are acts of terrorism”.

a logic circuit, (logic gate design and the VHDL design)

For this project, each team member is responsible to create and simulate a design either using Multisim or VHDL, but together the team must create both a design using Multisim AND VHDL. Team members will have to determine who will develop the design using standard logic gates and who will implement the design using VHDL. There are two design projects (Project 1 and Project 2 explained below) to choose from and two ways to implement the design (logic gates and VHDL). Therefore, to be clear, each team must decide which project they are going to do (Project 1 or Project 2), and then the team will have to decided who will do the design using a chip with logic gates and who will do the design using VHDL. There is an automatic 35 point deduction if the final product does not include both a logic gate design and VHDL design. Please note that the logic gate design should be implemented using IC Chips rather than individual logic gates. For instance, your design might include a 7400 quad nand gate, etc. Project 1Develop a logic circuit necessary to meet the following requirements:In a certain chemical-processing plant, a liquid chemical is used in a manufacturing process. The chemical is stored in three different tanks. A level sensor in each tanks produces a HIGH voltage when the level of chemical in the tank drops below a specified point.Design a circuit that monitors the chemical level in each tank and indicates when the level in any two of the tanks drops below the specified point.Project 2Develop a logic circuit necessary to meet the following requirements:A battery-powered lamp in a room is to be operated from two switches, one at the back door and one at the front door. The lamp is to be on if the front switch is on and the back switch is off, or if the front switch is off and the back switch is on. The lamp is to be off if both switches are off or if both switches are on. Let a HIGH output represent the on condition and a LOW output represent the off conditions.PAPER REQUIREMENTSPlease use this template to write a project paper which includes the following. NOTE: When using the template, please use the template headings in bold but do not include the description of each section in the final paper as that would be incredibly unprofessional.

a logic circuit, (logic gate design and the VHDL design)

For this project, each team member is responsible to create and simulate a design either using Multisim or VHDL, but together the team must create both a design using Multisim AND VHDL. Team members will have to determine who will develop the design using standard logic gates and who will implement the design using VHDL. There are two design projects (Project 1 and Project 2 explained below) to choose from and two ways to implement the design (logic gates and VHDL). Therefore, to be clear, each team must decide which project they are going to do (Project 1 or Project 2), and then the team will have to decided who will do the design using a chip with logic gates and who will do the design using VHDL. There is an automatic 35 point deduction if the final product does not include both a logic gate design and VHDL design. Please note that the logic gate design should be implemented using IC Chips rather than individual logic gates. For instance, your design might include a 7400 quad nand gate, etc. Project 1Develop a logic circuit necessary to meet the following requirements:In a certain chemical-processing plant, a liquid chemical is used in a manufacturing process. The chemical is stored in three different tanks. A level sensor in each tanks produces a HIGH voltage when the level of chemical in the tank drops below a specified point.Design a circuit that monitors the chemical level in each tank and indicates when the level in any two of the tanks drops below the specified point.Project 2Develop a logic circuit necessary to meet the following requirements:A battery-powered lamp in a room is to be operated from two switches, one at the back door and one at the front door. The lamp is to be on if the front switch is on and the back switch is off, or if the front switch is off and the back switch is on. The lamp is to be off if both switches are off or if both switches are on. Let a HIGH output represent the on condition and a LOW output represent the off conditions.PAPER REQUIREMENTSPlease use this template to write a project paper which includes the following. NOTE: When using the template, please use the template headings in bold but do not include the description of each section in the final paper as that would be incredibly unprofessional.

The post You are a manager of a clinical team and one of your appeared first on Smashing Essays.

 

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NURS 4100 – Nursing Care of Children Essay Paper

Objectives:

• Don’t like to mingle with others.
• When talked to, he always looked at different directions.
• Isolate him from others.
  We will write a custom essay sample on Nursing Care Plan for Impaired Social Interactionor any similar topic only for you

• Does not participate in ward activities.

Subjective: “Ayoko sa kanila makihalubilo minsan kasi pakiramdam ko sasaktan nila ako at pinagtritripan. ” |Impaired Social Interaction related to social isolation of self to others. A state in which an individual participates in either an insufficient or an excessive quantity of social exchange, or with an ineffective quality of social exchange. |Short Term: Within 1 week of nursing interactions and interventions, the patient will: NURS 4100 – Nursing Care of Children Essay Paper

1. Minimize his pacing in different directions when talked to.
2. Develop a therapeutic nurse-client relationship through frequent, brief contacts and an accepting attitude.
3. Respond to social contacts in the environment such as interacting with the staff for a specific period of time.

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Long Term: Within 3 weeks of nursing interactions and interventions, the patient will:

1. Demonstrate effective social interaction skills in both one-on-one and group settings.
2. Will maintain a good relationship with other patients.
3. Demonstrate appropriate social interactions.

Independent:

1. Provided opportunities for socialization and encourage participation in group activities.
2. Allowed patient time to reveal delusions to you without engaging in a power struggle over the content or the reality of the delusions.
3. Used a supportive, emphatic approach to focus on patient’s feelings about troubling events or conflicts.
4. Helped patient to identify behaviors that alienate him from the environment.
5. Assisted patient in learning neutral social topics such as weather or local events. Dependent: 1. Administered medications as ordered and checked after administering. NURS 4100 – Nursing Care of Children Essay Paper

Collaborative: 1. Encouraged same nurse to work with the client.

1. To increase the client’s abilities and confidence in socializing.
2. To understand the feelings he is experiencing.
3. Empathy conveys your caring, interest and acceptance of the client.
4. To explore the feelings he is undergoing.
5. To develop a greater success in social interactions.

To control signs and symptoms of hallucinations and delusions of the client and to verify if he swallowed the medicines.

1. To promote development of trusting relationship. |Short Term Outcome: Met After 1 week of nursing interactions and interventions the client was able to: 1. Minimized his pacing in different directions when talked to.
2. Developed a therapeutic nurse-client relationship through frequent, brief contacts and an accepting attitude.
3. Responded to social contacts in the environment such as interacting with the staff for a specific period of time. Long Term Outcome: NURS 4100 – Nursing Care of Children Essay Paper

Met After 3 weeks of nursing interactions and interventions the client was able to:

1. Demonstrated effective social interaction skills in both one-on-one and group settings.
2. Maintained a good relationship with other patients.
3. Demonstrated appropriate social interactions.

Vietnam’s population is older and older and it is important for young people, especially politicans, to seriously think about the issue of nursing homes. Should elderly parents live in nursing homes or not? Sending elderly parent into nursing homes is the best choice for them in the rest of their lives for three main reasons. First, elderly parents live in nursing homes will be good for their children. Nowadays, young people are too busy. They have o go to work and have no time to take care of their parents. NURS 4100 – Nursing Care of Children Essay Paper

They leave their parents at home lonely for whole day and feel nervous about their parents. Consequently, they can not concerntrate on their work and nursing homes are a good choice for them to send their parents into. Second, when elderly line in nursing homes, they can make friends with the people at the same age. They will fell very happy because they can chat whole day with their friends, do some helpful excercises such as jogging, tai chi, instead of being lonely at home when their children go to work.

Third, the most important reason, is that nursing homes can provide elderly parents with modern health care facilities. In nursing homes, professional doctors, nurses and high quality equipments are always available to take care of elderly parents. Doctors here also give them a suitable diet which is good for their health. Opponents of sending elderly parents into nursing homes say that elderly parents will fell lonely when they live far from their children and it is also against Vietnamese moral value. However, as stated previously, nursing homes are the place which provide old people with the best health care. Moreover, their children can come and visit them whenever they want. In conclusion, there are undoubtly many benefits to send elderly parents into nursing homes. Most of old people who live in nursing homes show that they live better and happier with their friend here. Sending elderly parents into nursing homes becomes an important issue for both young people and elderly parents themselves to think about. NURS 4100 – Nursing Care of Children Essay Paper

In Sprakes and Tyrer’s (2010) research article entitled “Improving Wound and Pressure Area Care in a Nursing Home”, the effectiveness of wound and pressure ulcer management was examined. The rate of wounds and pressure ulcers in a nursing home is often an indicator of the quality of care received as these injuries can lead to illness and a decreased quality of life (Sprakes & Tyrer, 2010). Sprakes and Tyrer have identified gaps in overall management of wound and pressure ulcers.

They have also identified a large volume of referrals regarding advice and support for wounds and pressure ulcers.

For these reasons the authors’ research was aimed toward whether utilization of a new wound and pressure ulcer management system in the nursing home would decrease rate and severity of these injuries (Sprakes & Tyrer, 2010). The reason this article was selected for critique was due to personal encounters with pressure ulcers in the nursing home setting and first-hand observations of the debilitating effects they can have on an individual. NURS 4100 – Nursing Care of Children Essay Paper

Summary Research took place in a nursing home that was selected due to observations of poorly managed wounds and pressure ulcers.

The authors’ overall aim of the research was to “improve outcomes for patients requiring wound and pressure ulcer management” (Sprakes & Tyrer, 2010, p. 47). The authors planned on meeting this goal through improving staff knowledge, improving documentation, and finally encouraging owners to uphold the proper standards of care. Before implementing their management framework, the authors obtained data to establish a control. The authors collected data over a six month period regarding frequency of wounds and pressure ulcers and regarding the number of times additional support nurses were contacted to aid with wounds/pressure ulcers.

Next, staff knowledge was assessed regarding wound and pressure ulcer assessment and management (Sprakes & Tyrer, 2010). The authors then created a unique competency-based framework. This competency-based framework served as the standard of care to be used throughout the project. It also served as an evaluating tool when measuring staff performance. From there the authors then went on to discuss the project with the staff. Concerns, barriers, and benefits were all discussed as the authors felt “if staff understand why change is occurring, they are more likely to implement the required change” (Sprakes & Tyrer, 2010, p.

47). When implementing their competency-based framework the authors selected four nurses to be supported through the program. Only four were chosen due to the amount of time required to support each individual member. The four nurses then received two theoretical training sessions with a day on wound assessment and a day on pressure ulcer prevention and management (Sprakes & Tyrer, 2010). Once complete, the nurses worked alongside one of the authors in implementing the framework in the clinical setting. Completion of the process took an average of six weeks per nurse (Sprakes & Tyrer, 2010). NURS 4100 – Nursing Care of Children Essay Paper

After completion of the program the four nurses had their knowledge reassessed and another set of data was collected over a six month period to allow time for the nursing staff to incorporate the framework into practice (Sprakes & Tyrer, 2010). After analyzing the data, the authors found a 77% decrease in the number of wounds and a 57% decrease in the number of pressure ulcers. The data also revealed a significant increase in wound and pressure ulcer documentation and a decrease in the number of contacts to supportive nurses. When reassessed the staff demonstrated an increase in knowledge and skill.

Overall the authors came to the conclusion that both the nursing staff and patients considerably benefited from the project. Based off the results, they encourage the implementation of similar projects in other nursing homes (Sprakes & Tyrer, 2010). Analysis of the authors’ references affirms their appropriateness to the study; however, 66% of the references used are not current as indicated by a publication date greater than 5 years. Critique Based on the article, the authors’ purpose of the study was apparent and the results were conclusive. NURS 4100 – Nursing Care of Children Essay Paper

The authors’ decision to implement an evidenced-based wound assessment tool was a great choice as it significantly benefited documentation rates as one was not being used in the nursing home prior. Through this choice it was evident that the authors were able to help the nursing staff to “ensure the credibility of their profession and provide accountability for nursing care” (North Carolina Concept-Based Learning Editorial Board, 2011, p. 2324). When analyzing the study it clearly demonstrates the impact that proper guidelines and education can have on wound and pressure ulcer management.

Through education the authors were able to aid the nursing home in preventing the occurrence of more wound and pressure ulcers as “prevention is the goal for the clients at risk for pressure ulcers” (NCC-BLEB, 2011, p. 1918). Although this article is a good resource for information and statistics on wound and pressure ulcers, it is not recommended for individuals looking for particular nursing interventions used for wound and pressure ulcers. While the authors did broadly explain their competency-based framework, they lacked depth in explaining specific information and interventions taught and used throughout the project.

In conclusion, this work greatly contributes to the nursing profession because it created a unique quality management plan that has the potential to better numerous nursing homes and improve the lives of many patients. References North Carolina Concept-Based Learning Editorial Board. (2011). Nursing: A concept-based approach to learning (Vols. 1-2, pp. 1915-1926, 2324, 2425). Upper Saddle River, NJ: Pearson Education, Inc. Sprakes, K. , & Tyrer, J. (2010). Improving wound and pressure area care in a nursing home. Nursing Standard, 25(10), 43-49. Retrieved from http://search. ebscohost. com/login. aspx? direct=true&db=rzh&AN=2010893921&site= NURS 4100 – Nursing Care of Children Essay Paper

Approximately 1.4 million elderly people reside in long term care facilities, such as nursing homes. The families that admit their loved ones to these long term care facilities believe that excellent care is being provided to them. Many of the residents in nursing home settings receive adequate health care, but a numerous amount of other residents are subjected to abuse and neglect. It is believed that nearly one-third of all nursing homes have residents that are subjected to abuse either by staff or other residents (Masters in Health Care).

Definitions of elder abuse vary. It is difficult to pinpoint exactly what actions or inactions constitute abuse. Besides a variety of definitions, the major types of abuse that occur in nursing homes are categorized into physical abuse, sexual abuse, emotional or psychological abuse, neglect, abandonment, financial or material exploitation. The solution to such nursing home abuse is rather simple. To prevent the inhumane treatment of the elderly in nursing homes, the nursing shortage needs to be addressed. NURS 4100 – Nursing Care of Children Essay Paper

The scandal of elder abuse in nursing homes appears to be new phenomena, but in reality this god forsaken crime has occurred for decades. Due to an elder’s physical and cognitive make up, they are not able to defend themselves from the heinous acts of abuse by their caregivers. Abuse in nursing homes is mainly thought of as physical aggression, but the elderly are subjected to psychological abuse also. One would think that no man or woman could commit abuse onto a helpless individual; however the issue of elderly abuse in nursing homes has been a growing problem. In 2003, there were 20,673 complaints of abuse, gross neglect, and exploitation on behalf of nursing home and “board and care” residents (American Association for Justice). By 2010 the number of elderly abuse complaints rose to a number between one million and two million (National Center on Elder Abuse). NURS 4100 – Nursing Care of Children Essay Paper

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A study prepared by the staff of the Special Investigations Division of the House Government Reform Committee found that thirty percent of nursing homes in the United States (5,283 facilities) were cited for almost nine-thousand instances of abuse over a recent two year period. The common problems of the study included untreated bedsores, inadequate medical care, malnutrition, dehydration, preventable accidents, and inadequate sanitation and hygiene. These common problems can be categorized into the major types of elder abuse in nursing homes. Physical abuse, sexual abuse, psychological abuse, neglect, abandonment, and financial exploitation are considered the major types of such abuse.

Physical abuse is defined by the use of physical force that may result in bodily injury, physical pain, or impairment. Physical abuse may include but is not limited to such acts of violence as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. In addition, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse (National Center on Elder Abuse). Nearly sixteen-percent of nursing home abuse cases involve physical abuse (Brent & Adams). An article published by ABC news interviewed Helen Love, a 75 year-old grandmother of three that was a victim of nursing home abuse. Helen told ABC, “He choked me and he went and broke my neck. NURS 4100 – Nursing Care of Children Essay Paper

He broke my wrist bones, in my hand. He put his hand over my mouth.” Two days after the interview, Helen Love died. Nursing home officials did not report her beating to a state official who was at the nursing home at the time. Ultimately, though, Love’s attacker served a year in prison. An investigation revealed that he had been fired by two previous nursing homes for aggressive behavior. A report by the Senate Select Committee on Aging found that many nursing home abuse cases are not immediately reported to law enforcement official (Robinson). In fact, a recent report indicated that one in fourteen incidents of elder abuse where not reported to the authorities (American Association of Justice).

Emotional or psychological abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological abuse includes but is not limited to verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person like an infant; isolating an elderly person from his/her family, friends, or regular activities; giving an older person the “silent treatment” and enforced social isolation are examples of emotional/psychological abuse (National Center on Elder Abuse). Almost twenty percent of reported elder abuse cases involve emotional abuse (Brent & Adams). With emotional abuse being the most abundant, it is also the most difficult to define. Emotional abuse is purely subjective which therefore is difficult to reprimand nurses against these crimes. The other major crimes however are objective, and are more easy to identify, such as neglect. NURS 4100 – Nursing Care of Children Essay Paper

Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations or duties to an elder. Neglect may also include failure of a person who has fiduciary responsibilities to provide care for an elder (e.g., pay for necessary home care services) or the failure on the part of an in-home service provider to provide necessary care (National Center on Elder Abuse). According to Brent & Adams, twelve percent of abuse cases involve caretaker neglect.

Neglect typically means the refusal or failure to provide an elderly person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials included in an implied or agreed-upon responsibility to an elder (National Center on Elder Abuse). The Federal Bureau of Investigation published an article in May of 2012 about a case of nursing home neglect. The owner of three Georgia nursing homes, George Dayln Houser, was convicted in Atlanta of defrauding Medicare and Medicaid for $32.9 million dollars.

To receive Medicare and Medicaid payments, Houser agreed to provide his residents with a safe and clean physical environment, nutritional meals, medical care, and other assistance. Houser not only failed to maintain a nursing staff sufficient to take proper care of the residents but did not pay food suppliers or providers of pharmacy and clinical laboratory services, medical waste disposal, trash disposal, and nursing supplies (FBI). Neglect, alongside physical abuse, are the most detrimental to a residents health. Not only do caregivers subject their residents to the atrocious crimes of neglect, but they also exploit them financially and materially. NURS 4100 – Nursing Care of Children Essay Paper

Financial or material exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets. Examples include, but are not limited to, cashing an elderly person’s checks without authorization or permission; forging an older person’s signature; misusing or stealing an older person’s money or possessions; coercing or deceiving an older person into signing any document; and the improper use of conservatorship, guardianship, or power of attorney (National Center on Elder Abuse). In 2009, a Chicago nursing home worker faced financial exploitation and aggravated identification theft charges for allegedly stealing $4,008 from a Illinois nursing home. The criminal remained free on bail and was fired from the Illinois nursing home. Authorities acknowledge that the criminal had a previous criminal conviction for forgery (Nursing Home Blog).

The major types of nursing home abuse have a direct correlation to inadequate staffing levels. A recent statistic by the American Association for Justice, found that ninety-percent of United States nursing homes had staffing levels too low to provide sufficient care. Residents of those nursing homes falling below minimal staffing standards are much more likely to develop bedsores and experience excessive weight loss than those in other nursing homes. This is because enough staff must be available so that all residents who cannot eat by themselves receive help. Also, unless immobile elderly residents are repositioned frequently, they may develop bedsores. To add to the problem, understaffing contributes to low morale and frustration among employees, decreasing their ability to deal with residents patiently and respectfully. NURS 4100 – Nursing Care of Children Essay Paper

According to the American Association for Justice, a series of reports revealed that many nursing homes do not have enough staff to meet the levels recommended by federal officials (3.45 nursing hours per patient daily) and nursing home experts (4.55 nursing hours per patient). Insufficient hours per patient hosts all sorts of potential problems for nursing care, the most problematic being neglect.

Many nursing home residents need constant nursing attention to ensure that they do not develop medical problems. In many cases, residents need to be turned, moved, or given skin assessments to avoid developing pressure ulcers or from forming deadly blood clots. John A. Fisher, Ph. D, said there have been an alarming amount of recent cases in which New York nursing homes have been found liable for elder abuse after a resident died or was injured due to inadequate care. In every case, inadequate staffing was named as a contributing factor to the cause of the abuse. With inadequate staffing being the undeniable cause of nursing home abuse, how does the projected nursing shortage effect this issue?

The projected nursing shortage in the United States is expected to intensify as baby boomers age and the need for health care grows. “In the July/August 2009 Health Affairs, Dr. Peter Buerhaus and coauthors found that despite the current easing of the nursing shortage due to the recession, the U.S. nursing shortage is projected to grow to 260,000 registered nurses by 2025. A shortage of this magnitude would be twice as large as any nursing shortage experienced in this country since the mid-1960s. In the article titled The Recent Surge In Nurse Employment: Causes And Implications, the researchers point to a rapidly aging workforce as a primary contributor to the projected shortage (American Association of Colleges of Nursing).” NURS 4100 – Nursing Care of Children Essay Paper

In some instances today, nurses are forced to attend to 20 patients at a time, and that is at the lower part on the nurse- patient spectrum. Federal law requires Medicare and Medicaid certified nursing homes to have an registered nurse (RN) director of nursing (DON); an RN on duty at least 8 hours a day, 7 days a week; and a licensed nurse (RN or LPN) on duty the rest of the time. However, there are no minimum staffing levels for nurse’s aides, who provide most of the day-to-day care. Instead, nursing homes are required “to provide sufficient staff and services to attain or maintain the highest possible level of physical, mental, and psychosocial well-being of each resident. (Elder Law Answers)” If a nursing home met only the federal nurse staffing requirements described above, a resident would receive 20 minutes of nurse time per day.

In 2000, the Centers for Medicare and Medicaid Services (CMS) reported that the preferred minimum staffing level was when nursing home residents received three hours of total staff time per day — two hours of nursing assistant time and one hour of licensed nurse time. The optimum staffing level, according to the CMS, is one hour of licensed nurse time and three hours of nursing assistant time (Elder Law Answers).

Most states have standards that are higher than the federal requirements, but still fall short of the levels recommended by the CMS. According to a recent study, the key to improving nursing home staffing levels is increasing state standards. The study by Charlene Harrington, a UCSF School of Nursing professor, found that states with the highest standards for nursing staff levels are the only states where nursing homes have enough staff to prevent serious safety violations. According to the study, the act of raising the state minimum staffing ratio has a direct impact on the quality of care nursing home residents receive. With such an impact that state and federal standards have on quality of care, how can the state enforce nursing homes to follow such mandates? NURS 4100 – Nursing Care of Children Essay Paper

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According to an article published by nursing home reality endorsed by Aaron Delurey, the best way to ensure that residents are receiving an ample amount of care is for state officials to introduce these three procedures: Have each state mandate an increase in the percentage of surprise inspections that must take place outside of regular business hours on weekdays. Second, require management personnel to work staggered shits all the time, not just when the state is in their building. Why require this change?

When the management is out of the building the quality of care given often suffers. Third and foremost, when the state shows up for an any kind of inspection, the inspectors should immediately seize the payroll data to verify staffing levels for the 14 continuous days immediately prior to the inspection. The inspectors should also insist that while they are in the building that no additional staff can be called in. These procedures would ultimately address the nursing shortage, therefore depleting the abuse within nursing homes. NURS 4100 – Nursing Care of Children Essay Paper

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