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Week 5 Discussion-Government homework Assignment

Week 5 Discussion-Government homework Assignment

Propose a Change

In your initial discussion post this week present an argument that proposes one change to our electoral system. (Please note, it will not be acceptable to say you do not think any change should be made.)

Several possible changes to could be:

Eliminating the Electoral College

Instituting required Voter ID

Allowing felons to vote.

Mandatory voting.

Instituting an Election Day Holiday in which all Americans do not have to vote.

You may also get creative and come up with your own original change!

Just be sure to go beyond just stating what change you want to make, but present an argument for why we should make that change and how that change would improve our electoral system.

In your argument, do not use words like “fair” or “good” or “better” or “equal” – how do you measure what is or is not “fair”? What if you and I have different definitions of what is or is not fair (these are not universal terms)?

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Summarizes information gleaned from sources to support major points, but does not synthesize. 14 to 15 points

Summarizes information gleaned from sources to support major points, but does not synthesize. 14 to 15 points

Order Description
Write a 3- to 4-page literature review that includes the following:
A synthesis of what the studies reveal about the current state of knowledge on the question that you developed
Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.
Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry
Your literature review summary table with all references formatted in correct APA style

Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.
Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library?s databases.
Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week?s Learning Resources.
Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

In nursing what is the effect of staffing by number compared to acuity during a shift?
Chutney E. Walley
Walden University

In nursing what is the effect of staffing by number compared to acuity during a shift?
Staffing adequately improves patient care. When you staff with numbers you staff by patient nurse ratio. If you have a floor of twelve patients and three nurses, your patient nurse ratio will be 4:3. Looking at acuity you staff based on the level of care that has to be given. For example, if you have ten patients and two of them are a level three for care; the nurse that has those patients gets the least number of patients. The current organization that I work for staff by number. I have found that staffing by acuity in smaller hospitals is much easier versus a large hospital. California is one of the few states that has laws that regulate patient nurse ratio. ?However, as the proportion of hospital nurses working shifts of more than thirteen hours increased, patients? dissatisfaction with care increased. Furthermore, nurses working shifts of ten hours or longer were up to two and a half times more likely than nurses working shorter shifts to experience burnout and job dissatisfaction and to intend to leave the job. Extended shifts undermine nurses? well-being, may result in expensive job turnover, and can negatively affect patient care.? (Stimpfel, 2012)
Significance of the problem
Staffing is one of the biggest problems we face in nursing. Inadequate staffing over a period of time causes nurses to become burnt out, medical errors, and poor patient care. ?Despite regulations on shift length and cumulative working hours for resident physicians and people in other industries, there are no national work-hour policies for registered nurses.? (Stimpfel, 2012) When we staff by numbers and the nurse has patient five to six patients with high acuity the level of care declines. Most nurses work twelve hour days so this opens the door for medical errors.
?In 1999, California became the first state in the United States to pass legislation requiring minimum nurse-to-patient staffing ratios in acute care hospitals. The legislation, for which nursing unions were outspoken advocates, was, in part, a response to a reported decline in hospitals’ nurse staffing and skill mix induced by pressures from increasing managed care penetration. California Assembly Bill (AB 394) required the California State Department of Health Services to establish unit-specific minimum staffing levels for licensed nurses (registered nurses [RNs] and licensed vocational nurses [LVNs]) in acute care hospitals. The draft regulations were released in January 2002 and, after a period of highly contentious public comment, implemented in January 2004.? (Mark, 2013).
In my years of practice, I have seen both the risk and benefits of staffing by numbers and acuity. There have been days where we have had seven patients to care for with high acuity levels for twelve hours, and the patient level of care was decreased.
Questions
Should all states make it mandatory for a set patient nurse ratio? Should states make it mandatory to staff by acuity? Should nurses have a limit on shift lengths like other professions? States that have regulations in place, should it be an exception when looking at acuity? Looking at evidence based practice what has proven to be the best way to staff nurses? I understand that one way will not work for all hospitals. When you have smaller hospitals it is much easier to stay by acuity. In order to continue to improve patient care we have to work on improve conditions such as staffing for nurses.

PICOT Question. The PICOT question I chose was ?In nursing what is the effect of staffing by number compared to acuity during a shift?? The variables for this question population, factor, comparison, outcome and time. Nurses are considered the population and staffing is the factor of patient care. I am comparing acuity staffing to number staffing during a shift.
Keywords. Using key words has help me find lots of literature about my topic. Key words to research this topic is staffing; nurses; acuity; nurse patient ratio, and numbers. I also used assignment, work environments, healthcare support, outcomes, and burnouts to search for data.

Conclusion. Staffing can be very frustration, but we have to remember it?s for the safety of the patient. Improving staffing improves both patient and employee satisfaction. Staffing by acuity or numbers should always be considered if it benefits the patient and causes less stress on nurses. Staffing will always be one of our greatest down fall in nursing
References
Mark, B. A., Harless, D. W., Spetz, J., Reiter, K. L., & Pink, G. H. (2013). California?s Minimum Nurse Staffing Legislation: Results from a Natural Experiment. Health Services Research, 48(2 Pt 1), 435?454. http://doi.org/10.1111/j.1475-6773.2012.01465.x
Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs (Project Hope), 31(11), 2501?2509. http://doi.org/10.1377/hlthaff.2011.1377

Evaluation Criteria for Applications and Formal Papers

Levels of Achievement
Criteria Outstanding Performance Excellent Performance Competent Performance Proficient Performance Room for Improvement
QUALITY OF WORK SUBMITTED –
1. The extent to which work meets the assigned criteria and work reflects graduate level critical and analytic thinking (0-30 Points) 30 to 30 points
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics 25 to 29 points
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics 20 to 24 points
Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics. 16 to 19 points
Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed. 0 to 15 points
Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.
QUALITY OF WORK SUBMITTED: Purpose of the paper is clear (0-5 Points) 5 to 5 points
A clear and comprehensive purpose statement is provided which delineates all required criteria. 5 to 5 points
A clear and comprehensive purpose statement is provided which delineates all required criteria. 4 to 4 points
Purpose of the assignment is stated, yet is brief and not descriptive. 1 to 3 points
Purpose of the assignment is vague. 0 to 0 points
No purpose statement was provided.
ASSIMILATION AND SYNTHESIS OF IDEAS
The extent to which the work reflects the student?s ability to-
1. Understand and interpret the assignment?s key concepts (0-10 Points) 10 to 10 points
Demonstrates the ability to critically appraise and intellectually explore key concepts. 9 to 9 points
Demonstrates the ability to critically appraise and intellectually explore key concepts. 8 to 8 points
Demonstrates a clear understanding of key concepts. 5 to 7 points
Shows some degree of understanding of key concepts. 0 to 4 points
Shows a lack of understanding of key concepts, deviates from topics.

ASSIMILATION AND SYNTHESIS OF IDEAS 2. Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources (0-20 Points) 20 to 20 points
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view. 15 to 19 points
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view. 10 to 14 points
Integrates specific information from 1 credible outside resource and 3 to 4 course resources to support major points and point of view. 3 to 9 points
Minimally includes and integrates specific information from 2-3 resources to support major points and point of view. 0 to 2 points
Includes and integrates specific information from 0 to 1 resource to support major points and point of view.
ASSIMILATION AND SYNTHESIS OF IDEAS 3. Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, and textbook) by comparing different points of view and highlighting similarities, differences, and connections. (0-20 Points) 20 to 20 points
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice. 18 to 19 points
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice. 16 to 17 points
Summarizes information gleaned from sources to support major points, but does not synthesize. 14 to 15 points
Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped. 0 to 13 points
Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.
WRITTEN EXPRESSION AND FORMATTING 1. Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance. (0-5 Points) 5 to 5 points
Paragraphs and sentences follow writing standards. 5 to 5 points
Paragraphs and sentences follow writing standards. 4 to 4 points
Paragraphs and sentences follow writing standards 80% of the time. 3 to 3 points
Paragraphs and sentences follow writing standards 70% of the time. 0 to 2 points
Paragraphs and sentences follow writing standards < 70% of the time. WRITTEN EXPRESSION AND FORMATTING 2. English writing standards: Correct grammar, mechanics, and proper punctuation (0-5 Points) 5 to 5 points
Uses correct grammar, spelling, and punctuation with no errors. 5 to 5 points
Uses correct grammar, spelling, and punctuation with no errors. 4 to 4 points
Contains a few (1-2) grammar, spelling, and punctuation errors. 3 to 3 points
Contains several (3-4) grammar, spelling, and punctuation errors. 3 0 to 2 points
Contains many (= 5) grammar, spelling, and punctuation errors that interfere with the reader?s understanding.
WRITTEN EXPRESSION AND FORMATTING 3. The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list (0-5 Points) 5 to 5 points
Uses correct APA format with no errors. 5 to 5 points
Uses correct APA format with no errors. 4 to 4 points
Contains a few (1-2) APA format errors. 3 to 3 points
Contains several (3-4) APA format errors. 0 to 2 points
Contains many (= 5) APA format errors.


 

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Discuss why cost management and cost allocation is important information for a healthcare manager?

Discuss why cost management and cost allocation is important information for a healthcare manager?

Answer the Following

Explain why cost management and cost allocation is important information for a healthcare manager?

What are indirect or overhead costs? Discuss one method in which overhead costs can be allocated?

What is the degree of operating leverage? What does it mean if one firm has a measure of 40% and the other has a measure of 50%, which is better?

Define fixed cost and provide an example of a fixed cost in a healthcare setting.

Define variable cost and provide an example of a variable cost in a healthcare setting.

Once you posted your initial discussion based on the above, respond to TWO of your fellow classmate’s responses in an area different from what you responded to initially.

Make sure you are properly citing your source(s) and providing your reference(s) for information you obtain from another source. Please review the Discussion Expectations and Grading posting if you have any questions regarding answering the discussion question and/or responding to your peers.

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Discuss at least one primary, one secondary and one tertiary prevention intervention for the epi problem based on professional journals and appropriate web sources. (Define primary, secondary, and tertiary prevention in your discussion).

Discuss at least one primary, one secondary and one tertiary prevention intervention for the epi problem based on professional journals and appropriate web sources. (Define primary, secondary, and tertiary prevention in your discussion).

Paper details:
Please see rubric
APA 7 page ( seven references ? 5 scholarly journal article one book ? ISBN ? provided

Epidemiology Paper Purpose
The Epidemiology paper is an in depth study of a community or population public health problem. The purpose of the papers is for students to demonstrate the fundamental community health skills:

Describe the public health problem using appropriate epidemiology statistics and HealthyPeople.org using descriptive epidemiology.
Analyze the health problem using epidemiology and theoretical models (including its epidemiology and previously tried solutions) using analytical epidemiology
Propose a plan to solve the problem, including all three levels of prevention.
Discuss evidence-based recommendations for decreasing or elimination the problem
Please review the Epidemiology Scholarly Paper Rubric below for detailed explanations of what is to be discussed and included for each section and points assigned.

NOTE: You must receive at least a 24% originality report for the paper to be graded. Please give yourself enough time. See Syllabus for more detailed information.

Grading Rubric for this assignment

(7 ? 8 pages excluding the Title Page and Reference Page)?APA Paper

Epidemiology Topic ?Smoking ( APA paper )
( This course is community health nursing- graduate level ) Please must citation and five scholar journal ..see attached article and use other scholar article as needed )
Points Possible
Introduction
Introductory paragraph that includes:
– General introduction of paper
– Selected epi problem
– Purpose of the paper (what you plan to write about/discuss)
10
Descriptive Epidemiology
Discuss: Using a descriptive epidemiology approach discussed in your textbook, describe the problem in terms of a) person, b) place, and c) time, incorporating factors from your textbook to describe the problem, and clearly differentiating between the three terms.( please type in Google descriptive epidemiology then choose Descriptive epidemiology pattern of disease person, place and time chapter 4 ) text book ISBN ? 9780323100946.. chapter 9 ,page no 164) please use citation of this book please here .
10
Incidence and Prevalence
Define incidence and prevalence. Compare the incidence and/or prevalence rates at the local, state, and national level. Hints -( Please discuss National level ? United States, State ? Colorado, Local ? Denver county )
10
HealthyPeople.gov
Identify and describe: Healthy People.gov objectives https://www.healthypeople.gov/including objective numbers relating to your epi issue. NOTE: You can find Healthy People.gov objectives at the web site: www.healthypeople.gov At this site, click the 2020 Topics and Objectives. Click the areas for which you want to find objectives.( Please discuss United States and Colorado state)
10
Theoretical Model
Describe the appropriate theoretical model (epidemiological triangle OR web of causation) and state why it is an appropriate model for understanding the epi issue. Explain how the problem develops or explain the “cause” of the health problem using the appropriate theoretical model (either Epidemiological Triangle or Web of Causation).
10
Levels of Prevention
Discuss at least one primary, one secondary and one tertiary prevention intervention for the epi problem based on professional journals and appropriate web sources. (Define primary, secondary, and tertiary prevention in your discussion).
Helpful tip: Go to CDC and type in Disease/problem name and prevention interventions. For example: Chronic Disease or STI prevention interventions/strategies. Hints -(see attach document for article )?nicotine vaccine ?see attached article ?First level of prevention ? promote health ,prevent occurrence of disease and ,Second level of prevention ? screening of disease ,Third level ? treatment )
15
Evidence-Based Practice
Discuss at least one evidence-based practice recommendation for addressing the problem. You may find programs at a) Community Preventive Guidelines at: http://www.thecommunityguide.org/ (Pick a topic listed that has evidenced-based interventions listed–click on a topic to see if there are interventions listed), b) Cochrane Database () for evidence-based practice recommendations, c) AHRQ http://www.ahrq.gov/ evidence-based practice recommendations or d) a professional journal article discussing evidence-based recommendations Hints- ( please use attach article for discussion ? exercise based smoking program, Workplace has potential settings through large group of people can be reached ? see attached article and you can also add more journal article ) can use more journal here .
10
Conclusion
Summarize findings, including the problem, prevalence / incidence, evidence-based programs, and community health nurse role(s).
10
Scholarly Paper Writing
Appropriate grammar, spelling and use of APA formatting in-text and reference page (at least 5 scholarly /research materials current within the last five years of publication).
10
Total points possible
Please write each content one page and total of seven page ? please give heading and sub heading
Please Data collection only on – United States and Colorado and local Denver county please use other website as below )

Week 4( please use online resources from this site also )

Epidemiology and health statistics web sites:
Behavioral Risk Factor Surveillance System: http://www.cdc.gov/brfss/ Behavioral Risk Factor surveillance system which allows you to view risks at the national, state and local levels

Burden of chronic disease and their risk factors by state:

Go to: http://www.cdc.gov/chronicdisease/states/index.htm
Click the state of your choice
Cancer Mortality Maps and Graphs: http://www3.cancer.gov/atlasplus/

Center for Disease Control WONDER: http://wonder.cdc.gov/ This database can be queried for mortality and morbidity information along with specific disease statistics by region, gender, etc..

Center for Disease Control Data and Statistics: http://www.cdc.gov/DataStatistics/ This is a VERY comprehensive site for accessing health data ranging from mortality to vital records. A number of the databases on the resource page are also incorporated into this web site.

Health Data Interactive: http://www.cdc.gov/nchs/hdi.htm

Great site for accessing national and state data.
Morbidity data: Chronic Disease Indicators and Prevalence by State and Nation

Go to: http://apps.nccd.cdc.gov/cdi/
Select a State and area for comparison
Select a category of indicators (Physical Activity and Nutrition for example) and click SEARCH. You will see prevalence data for the indicator
National Center for Health Statistics: http://www.cdc.gov/nchs/

National Center for Health Statistics FastStats from A-Z:
http://www.cdc.gov/nchs/fastats/default.htm

National Center for Health Statistics GIS and Public Health: Geographic maps of morbidity and mortality statistics
http://www.cdc.gov/nchs/about/otheract/gis/gis_atnchs.htm This is a great site for viewing Geographical Information Systems data which maps health statistics by geographic region. It displays how mortality and morbidity varies considerably by geography.

U.S. Department of Health & Human Services Healthy People 2010 Data 2010: http://wonder.cdc.gov/data2010/ You can track Healthy Peopl 2010 national data at this site.

Specific Population Health Statistics Web Sites:
Children’s Health (School-Age and Adolescents)

http://www.childstats.gov/americaschildren/
This web site contains reports on school-age and adolescent health.

http://www.monitoringthefuture.org/
This site provides survey results on adolescent health and attitudes/behaviors

http://www.cdc.gov/nccdphp/dash/yrbs/index.htm
This site is the Adolescent and School Health web site that has information on the Youth Risk Behavior Surveillance System.

http://mchb.hrsa.gov/publications/childhealthusa.html
This is the HRSA site for child health data

http://mchb.hrsa.gov/mchirc/_pubs/us_teens
This is the HRSA site for teen health data

Maternal-Infant Health

http://www.cdc.gov/reproductivehealth/Data_Stats/index.htm
This is the Center for Disease Control’s web site on Reproductive Health Information and data, including morbidity and mortality information.


 

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Sociology-Applied Sciences homework Assignment

Sociology-Applied Sciences homework Assignment

The thermal efficiency of a two stroke petrol engine as compared to that of a four stroke petrol engine for same output, same speed and same compression ratio is? explain. 1 page

The function of a differential in an automobile is? Explain 1 page

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Critically evaluate the case study utilizing the RLT Model for Nursing to provide holistic care to Elizabeth ? Critically analyse Elizabeth?s activities of living (ALs) to determine which interdisciplinary team members will need to be involved to ensure a collaborative approach to care ? Demonstrates knowledge of the requirements to prepare Elizabeth for discharge

Critically evaluate the case study utilizing the RLT Model for Nursing to provide holistic care to Elizabeth ? Critically analyse Elizabeth?s activities of living (ALs) to determine which interdisciplinary team members will need to be involved to ensure a collaborative approach to care ? Demonstrates knowledge of the requirements to prepare Elizabeth for discharge

Details of Assessment Tasks 1. Assessment task 1 Assessment Title Case Study Task Description Part A
Elizabeth is a 68 year old woman who has been brought into the Emergency Department. Paramedics handover the patient to you as the Registered Nurse working in the resuscitation room stating Elizabeth has been involved in a head-on Motor Vehicle Crash (MVC). They tell you that Elizabeth has a history of Atrial Fibrillation (AF), Hypertension (HT) and Osteoporosis and her current medications are Metoprolol, Warfarin and Calcium Carbonate. They also tell you Elizabeth lives alone and is complaining of right hip pain.
Using the ABCDEFG algorithm of assessment, outline the priorities of nursing assessment and care for Elizabeth based on the information provided in the case study. You should consider the mechanism of injury, patient history and current medications in your response. (1400words).
Part B
Elizabeth has been transferred to D6, an Orthopaedic Ward. He has had surgery on his hip for a fractured Neck Of Femur (#NOF). 6 weeks later, Elizabeth is ready to be discharged home. You are the nurse caring for Elizabeth on D6 and are preparing her for discharge.
Critically analyse what you will need to do as a nurse to prepare for Elizabeth to be discharged home. For this, you will need to utilise the Roper, Logan and Tierney Model for Nursing and also consider who you may need to incorporate from the interdisciplinary team to ensure a holistic and collaborative approach to care (1400words).
This assessment should include a brief introduction and conclusion (approximately 100 words each). This assessment should be structured as per the University?s assessment handbook guidelines. You may use headings for this paper. All information should be supported with current evidence from quality sources such as prescribed textbooks, journal articles, policies, procedures, guidelines and other reputable resources. Assessment Due Date Thursday 22nd September 2016 23:55pm (Week 9) Return Date to Students 21 days following submission Assessment Length 3000 words Weighting 50% Assessment Criteria Content ? 70% Evidence & Referencing ? 15% Presentation & Structure – 15% Referencing Style Author ? Date (Harvard) A summary of the Harvard system can be accessed in the online guide on the Library website at: http://public01.library.uow.edu.au/refcite/style-guides/html/ Submission Your assignment will be submitted into a Turnitin submission box within the NMIH305 Moodle site. You will have the opportunity to review and re-submit your assignment up to the due date and time. To learn more about how to use Turnitin please access the resources at the following link: http://www.uow.edu.au/dvca/ltc/tel/resourcehub/students/index.html
Subject Learning Outcomes Assessed
3,4,5,6

2 | Page
NMIH305: Care of People with Complex Conditions Assessment 1: Marking Guide ATTACH MARKING GUIDE AFTER REFERENCE LIST FOR HARDCOPY ASSIGNMENT SUBMISSION Student No ??????????.. Campus ????????. Tutorial Group ?????.
Criteria
Absent
Inadequate
Satisfactory
Good
Excellent
Marks
Part A ? Critically reviews the information provided to clearly outline the priorities of nursing assessment and care for Elizabeth using the ABCDEFG algorithm
0
1-17
17.5-22
23-29
30-35 /35
Part B ? Critically evaluate the case study utilizing the RLT Model for Nursing to provide holistic care to Elizabeth ? Critically analyse Elizabeth?s activities of living (ALs) to determine which interdisciplinary team members will need to be involved to ensure a collaborative approach to care ? Demonstrates knowledge of the requirements to prepare Elizabeth for discharge
0
0
0
1-7
1-4.5
1-4.5
7.5-10
5-6
5-6
11-13
7-8
7-8
14-15
9-10
9-10
/35
Evidence & Referencing ? All generalisations supported by current evidence ? Presents and describes a range of quality evidence including research-based literature, clinical practice guidelines, policy documents and textbooks ? Correct in-text referencing and formation of reference list
0 0
0
1-2 1-2
1-2
2.5-3 2.5-3
2.5-3
3.5-4 3.5-4
3.5-4
5 5
5
/15
Presentation and Structure ? Correct syntax, grammar, punctuation and spelling ? Appropriate margins, page numbering, font, style, page limit ? Introduction, body & conclusion well structured, easy to read
0 0 0
1-2 1-2 1-2
2.5 2.5 2.5
3.5-4 3.5-4 3.5-4
4.5-5 4.5-5 4.5-5
/15
This assignment is worth 50% of the total assessment for this subject. Comments
Marker?????????????????????????????Date ????.

/ 100
Late Penalty (if applicable):

3 | Page
2. Assessment task 2
Assessment Title Final Exam Task Description The exam will consist of multiple choice and short answer questions based on the content covered in tutorials, lectures, workshops and pre-readings throughout the semester. A pass rate of 50% in this exam must be achieved to pass/complete this subject.
Assessment Due Date UOW Exam Period Return Date to Students 1st December Assessment Length 120 minutes Weighting 50% Assessment Criteria N/A Referencing Style N/A Submission N/A
Subject Learning Outcomes Assessed
1,2,3,7


 

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Consumer Marketing Discussion

Consumer Marketing Discussion

Marketing homework task
300 word discussion board post in apa for

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Document questions-Operations Management homework Assignment

Document questions-Operations Management homework Assignment

First Questions

1.Why is it that rail does not have a greater share of the freight market in the United States?

2 What is required to make cross-docking a viable solution for a logistics provider? What are the pros and cons of relocating a small or mid-sized manufacturing firm (that makes mature products) from the United States to China?

3.Jacobs and Chase (2018, pg. 379) tell us, “…, there are many techniques available for identifying potential sites for plants or other types of facilities. The process required to narrow the decision down to a particular area can vary significantly depending on the type of business and the competitive pressures that must be considered. As we have discussed, there are often many different criteria that need to be considered when selecting from the set of feasible sites.” When I worked for AT&T we closed about 12 Network Operations Centers in the U.S and built one in Denver and one in Conyers, Ga (just east of Atlanta. Can anyone figure out what method or technique we used to identify potential relocation sites?

Second questions

  1. With so much productive capacity and room for expansion in the United States, why would a company based in the United States choose to purchase items from a foreign firm? Discuss the pros and cons. As a supplier, which factors about a buyer (your potential customer) would you consider to be important in setting up a long-term relationship?
  2. Describe how outsourcing works. Why would a firm want to outsource?
  3. There has been dramatic growth in outsourcing in the logistics area. Logistics is a term that refers to the management functions that support the complete cycle of material flow: from the purchase and internal control of production materials; to the planning and control of work-in-process; to the purchasing, shipping, and distribution of the finished product.” Why have we seen a shift on outsourcing of logistics? What are the benefits?

Third Questions

Summary of and thoughts on the topic of outsourcing

175 to 300 words each required.

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identify the goals which underpin the activities you have listed?. The applicant was requested to submit a revised plan, which she did on 30 July 2012

identify the goals which underpin the activities you have listed?. The applicant was requested to submit a revised plan, which she did on 30 July 2012

CITATION: ALISON PERRIN V HEALTH CARE COMPLAINTS COMMISSION [2013] NSWNMT 16

APPLICATION UNDER SECTION 163 (1) (a1) OF THE HEALTH PRACTITIONER REGULATION NATIONAL LAW (NSW)

Applicant: Alison Perrin

Respondent: Health Care Complaints Commission

Tribunal: The Hon. Jennifer Boland AM, Chairperson

 

Appellant: Ms Linda Alexander of the NSW Nurses and Midwives? Association appeared on behalf of the applicant.

Complainant: Ms Christine Campbell, Solicitor, appeared on behalf of the Health Professional Council Authority.

Ms Samantha King appeared on behalf of the Health Care Complaints Commission.
M
Council
Catchwords

Application under s 163 (1) (a1) of the Health Practitioner Regulation National Law (NSW) for review of conditions imposed on practitioner?s registration by a Professional Standards Committee to be heard by a Health Profession Council rather than the Nursing and Midwifery Tribunal – whether Tribunal or Council most appropriate body to hear review. HELD review should be determined by Council.

Legislation cited:

Health Practitioner Regulation National Law (NSW)
Health Legislation Amendment Act 2012 (NSW)
Nurses and Midwives Act 1991 (NSW) (repealed)

Cases cited:

Marks v Health Care Complaints Commission [2012]NSWNMT 16
Coe v Health Care Complaints Commission [2013] NSWNMT 11.
McAuley v Health Care Complaints Commission [2013] NSWNMT 13

REASONS FOR DECISION

What the Tribunal decided

1. On 12 September 2013, in my capacity as Chairperson of the Nursing and Midwifery Tribunal, I ordered that a review of conditions on the registration of Ms Alison Perrin imposed by orders made by a Professional Standards Committee on 18 August 2008 under the now repealed Nurses and Midwives Act 1991 (NSW) (?the repealed Act?) , should be conducted by the Council rather than the Tribunal.

Reasons for decision

2. These are the reasons for my orders. In these reasons, for convenience, I will refer to relevant persons and entities as follows:

(a) Ms Alison Perrin as ?the applicant?;
(b) the Nursing and Midwifery Tribunal as ?the Tribunal?;
(c) the Health Care Complaints Commission as ?the HCCC?;
(d) the Health Professional Council Authority as ?the HPCA?;
(e) the Nursing and Midwifery Council of New South Wales as ?the Council?;
(f) The New South Wales Nurses and Midwives? Association as ?the Association?;
(g) Ms Linda Alexander as ?Ms Alexander?. Ms Alexander is a solicitor employed by the Association;
(h) Ms Christine Campbell as ?Ms Campbell?. Ms Campbell is a solicitor in the employ of the HPCA.
(i) Ms Samantha King as ?Ms King?. Ms King is a solicitor in the employ of the HCCC; and
(j) The Professional Standards Committee as ?the Committee?.

Background

3. Unless stated to be an allegation the following facts were accepted by me as established to the requisite civil standard.

4. The applicant completed a Bachelor of Nursing degree at the University of Western Sydney in 2001. She undertook a New Graduate Programme at Royal North Shore Hospital (?RNSH?) in 2002, and was employed in that hospital in the neurosurgery ward from February 2003 until July 2006.

5. The parents of a teenage girl (Patient A) lodged a complaint with the HCCC about the care and treatment of their daughter at RNSH in November 2005. Patient A sustained a head injury (depressed skull fracture and contusion of the brain) as a result of an accidental injury. She was transferred from Hornsby Hospital to RNSH for neurological management on 6 November 2005. Patient A died at RNSH on 8 November 2005.

6. The Committee was convened on 1 July 2008 to conduct an inquiry into a Complaint brought against the applicant by the HCCC. On 18 August 2008 the Committee provided written reasons for its determination that the applicant was guilty of unsatisfactory professional conduct. The applicant was reprimanded under s 55 (1) of the repealed Act, and ordered to comply with four conditions (Orders 2 to 5) as follows:

2. If the Respondent resumes practice in the acute care clinical setting that she not be placed in charge of a shift for a period of six months.

3. That the respondent prior to undertaking in charge of shift be mentored by senior nursing staff in the charge role and responsibilities for a minimum period of six months.

4. The Respondent is required to inform her current employer and her first employer, should she return to the acute care setting, of these proceedings and the decision of the Committee including conditions applying to her registration.

5. The Respondent?s first employer in the acute care setting must not be a nursing agency.

7. In 2008 the applicant, through the association, requested the then Nurses and Midwives? Board to clarify certain aspects of Orders 2 to 5 of the orders made on 18 August 2008.

8. By letter dated 20 October 2008 the Council explained:

In relation to Order 3, the clarification is as follows:-
? As you have not worked in the acute care clinical role for some time;
– should you resume nursing practice in the acute care setting, you should initially work in the role of a registered nurse and not in the ?in charge role? nor in any in charge of shift role for a period of 6 (six) months (Ref. Order 2). During this period of employment you are to be mentored in your work by senior nursing staff.
– Subsequently, should you undertake ?higher duties? in the acute care clinical settling, and if this work is in the ?in charge role? or the ?in charge shift role?, you should at the outset be monitored for a minimum period of 6 (six) months by senior nursing staff while you are in the ?in charge? position.

9. The Council also provided further explanation of Orders 2, 4 and 5 and noted ?These Orders are to remain in place until each of the conditions has been met and the Orders fully complied with?.

10. By letter dated 12 August 2009 the applicant wrote to the Board (by letter addressed ?To Whom it May Concern?), and advised she was commencing a 12 month Temporary Full Time contract position as a registered nurse at Blacktown Hospital. The applicant advised her employment would be in the Intensive Care Unit and that she intended to take leave from her then employment at St Joseph?s Hospital, Auburn where she was employed as a ?TEN CNE?. The applicant?s employer was advised of the orders, and the Director of Nursing and Midwifery at the Blacktown Hospital advised the Council that the applicant would be working within the restrictions placed on her registration.

11. On 6 April 2011 the applicant wrote to the Council noting that she had been employed in the acute care area from 12 August 2009 ?to the present? without taking an ?in charge of ward position?. The applicant asked that Order 2 of the orders be discharged. The applicant further explained that she had obtained a part-time secondment position at Blacktown Hospital, and if the opportunity to take an in charge of shift position occurred, she would seek monitoring from senior staff, a situation she explained that the Nurse Unit Manager was happy to support.

12. On 28 April 2011 the Council wrote to the applicant, and having noted the applicant?s employment at Blacktown Hospital in an acute care area since August 2009, requested that she provide evidence that her work was monitored during the first six months of her employment, and ?that you have not worked in an ?in charge role? or ?in charge of shift role? since commencing employment in an acute care area?.

13. In its letter dated 28 April 2011 the Council also advised:

In relation of Order 3, a suitable mentor may be identified by you however the mentor must be approved by the Council before commencing the role. You are therefore requested to prove a Curriculum Vitae (CV) of your proposed mentor prior to commencing the ?in charge? role. A copy of the Council?s Mentor Policy is attached for your information. The Council will write to both you and your mentor once the mentor is approved.

14. On 8 February 2012 the applicant wrote to the Council in response to a letter from the Council dated 31 January 2012 (which sought an urgent update of the applicant?s compliance with the conditions imposed by the orders). The applicant advised she had been monitored by senior staff in the ICU at Blacktown Hospital for a period of six months from the commencement of her employment in August 2009. She also confirmed she had not taken any ?in charge of shift role? since commencement of her employment at Blacktown Hospital. The applicant also advised she had made arrangements for a senior nurse to act as a mentor for her for a period of six months during which period she would be attending ALS training and a 12 week Team Leader Development course run by Blacktown Hospital.

15. The applicant subsequently provided the Council with a curriculum vitae for her proposed mentor.

16. On 6 March 2012 the applicant?s Nurse Unit Manager wrote to the Council confirming the actions undertaken by Blacktown Hospital to monitor the applicant?s performance during the first six months of her employment.

17. On 30 April 2012 the Council wrote to the applicant confirming approval of the applicant?s proposed mentor, and made recommendations about a suitable mentoring plan. The applicant responded to the Council?s comments and set out the steps she proposed to undertake during the forthcoming six months to prepare for an ?in charge? role. She explained that she had undertaken a Critical Care 6 week Short Court in November 2009. She also explained she had undertaken a ?Team Leader Roles and Responsibilities? course through the Royal College of Nursing (Feb 2010).

18. On 21 June 2012 the Council wrote to the applicant acknowledging her mentoring plan and provided feedback on that plan. While noting the satisfactory aspects of the plan, the Council explained that the plan did not ?identify the goals which underpin the activities you have listed?. The applicant was requested to submit a revised plan, which she did on 30 July 2012.

19. On 28 November 2011 the applicant wrote to the Council enclosing copies of her mentoring report, performance appraisal and reflection journal. She advised that she had arranged with her Nurse Unit Manager to commence taking in charge nursing shifts with monitoring by senior nursing staff from 3 December 2012 for a period of six months. The applicant submitted that, on compliance with the monitoring period and appropriate confirmation of monitoring, the conditions imposed on her registration be lifted.

20. By letter dated 28 December 2012 the Council wrote to the applicant. The letter advised the applicant of the requirement for a Tribunal to consider whether the conditions imposed by the orders should be lifted as provided in the Health Profession Regulation National Law (NSW) (?the National Law?) and the availability of an application under s 163 (1) (a1) of that law to the Chairperson of the Tribunal to determine the appropriate review body. The letter also pointed out that ?the letter from the Nursing and Midwifery Board dated 20 October 2008 specified that the monitoring be for a minimum period of six months, and an appropriate review body could require a further period of monitoring ?before your conditions are lifted??.

21. On 27 July 2013 Ms King, on behalf of the HCCC, wrote to Dr Margaret Cooke, Executive Office of the Council advising that the HCCC would not oppose the matter being dealt with by the Council as the appropriate review body and said: ?It is a matter for the Chairperson of the Tribunal?.

22. By letter dated 1 August 2013 and received by the Tribunal on 6 August 2013 the Council indicated its willingness to act as the review body. Further, the Council supported this application being dealt with ?on the papers? without the need for a formal hearing of the application.

Procedural History

23. A directions hearing in respect of the application under s 163 (1) (a1) was conducted by me on 26 July 2013. I made directions for the filing of any relevant documents and submissions. I was subsequently provided by the Association with a copy of the reasons for decision of the Committee, and copies of the documents summarised by me under the heading ?Background? in these reasons. All concerned with the application agreed the matter could appropriately be dealt with ?on the papers? without a formal hearing thus minimising costs.

The Law

24. Section 163A, which is found in Division 8 of the National Law, provides that a person may apply to the appropriate review body for, inter alia, a review of a relevant order made in relation to the person. Person is not defined in the National law, but it may be implied a person for the purpose of the section is a person affected by an order made by ?an appropriate review body?. The definition of appropriate review body includes the both the Council and the Tribunal.

25. Section s163A(3) places constraints on when an application for review may be filed. Those constraints are irrelevant in the circumstances of this application.

26. Section 163A (4) defines the subject matter of a review in that it explains what constitutes ?a relevant order?, and immediately after s163A(4) the National Law defines the bodies who are a ?decision making entity?. The relevant sub-sections of s163A to be considered in this application are s163A (1) and (4). They provides as follows:

(1) A person may apply to the appropriate review body for a review of ?
??.
(b) a relevant order made in relation to the person

(4) In this section ?
????
relevant order, in relation to a person, means any of the following
orders made by a decision-making entity ?
???.

(c) an order that conditions be imposed on the person?s registration in a health profession

27. A ?decision making entity? is defined in s163A (4) as follows:

(4) In this section–“decision-making entity” means the following–
(a) a Committee;
(b) a Performance Review Panel;
(b1) a Council, but only in relation to orders made under this Division or under Subdivision 5 of Division 3;
(c) the Chairperson or Deputy Chairperson of a Tribunal;
(d) a Tribunal;
(e) the Supreme Court.

28. The determination of the appropriate review body to deal with any properly brought review is set out in s 163. That section was amended by the Health Legislation Amendment Act 2012 (NSW). It provides as follows:

163 Appropriate Review Body NSW
(1) For the purposes of this Division, the “appropriate review body” is-
(a) if the order being reviewed provides that it may be reviewed by a Council, the Council; or
(a1) if the Chairperson of the Tribunal decides, on application by the person the subject of the review or the Commission, that a Council is the appropriate review body, the Council; or
(b) if the Chairperson of the Tribunal decides, on application by the person the subject of the review, that a National Board is the appropriate review body, the National Board; or
(c) otherwise, the Tribunal.
(2) An application for review by a person must be lodged with the Executive Officer of the Council for the health profession in which the person is or was registered.
(3) The Executive Officer must refer the application to the appropriate review body.

29. In Marks v HCCC [2012] NSWNMT 16 I explained:

The powers to be exercised on a review are set out in s163B. The language of the section makes it plain that appropriate review body is mandated to conduct an inquiry into the application for review. Inquiry is not defined in the legislation, but in my view and without the benefit of any argument on the topic, it appears the type, or perimeters of, the inquiry are guided by the provisions set out in the s163C. As that provision is relevant to the exercise of discretion under s163 (a1) I now set out that section:

163C Inquiry into review application [NSW]
(1) A review under this Division is a review to determine the appropriateness, at the time of the review, of the order concerned.
(2) The review is not to review the decision to make the order, or any findings made in connection with the making of that decision.
(3) In addition to any other matter the review may take into account, the review must take into account any complaint made or notified to a Council or a National Board, or a former Board under a repealed Act, about the person, whether the complaint was made or notified before or after the making of the order that is the subject of the review and whether or not the complaint was referred under Subdivision 2 of Division 3 or any other action was taken on the complaint.

The written submissions

30. The material provided to me includes the applicant?s written submissions. These submissions do not directly address the question of the appropriate review body, but rather are principally directed as to why she submits the orders imposing the conditions should be discharged. She notes that, following the decision of the Committee, she was reprimanded because of the finding she was guilty of unsatisfactory professional conduct which arose from her care of Patient A on 8 November 2008, and that four other conditions were placed on her registration. The applicant submits:

As the Committee expected I have learnt from the incident, but not only the incident. I have also learnt from the conditions that were placed on my Registration.

31. As noted the Council and the HCCC, do not oppose the applicant?s position that the Council be the appropriate review body.

32. In three previous decisions to determine the appropriate review body I have canvassed, without providing an exhaustive list, relevant criteria to be taken into account in dealing with applications under s163 (1) (a1) (see Marks v Health Care Complaints Commission [2012] NSWNMT 16 and Coe v Health Care Complaints Commission NSWNMT [2013] 11 and McAuley v Health Care Complaints Commission NSWNMT [2014] 13. In Marks I explained relevant considerations include the nature of the original complaint which led to the orders imposing conditions, to the imposition of costs to the parties, and the proper use of the Tribunal and the Council?s resources. In Coe at [46-47], in determining the review should be by the Tribunal, I recorded:

Factors in favour of the Tribunal remaining the review body include:

? The fact the order imposing the condition restricting the nurse?s authority to possess and supply Schedule 4D and Schedule 8 drugs was made by a Tribunal after hearing and determination that complaints of professional misconduct and unsatisfactory professional conduct were proven;
? that the proceedings before the Tribunal were not the first proceedings before the Tribunal, the nurse having been subject of complaints in 2001 also of professional misconduct and unsatisfactory conduct which were conceded by the nurse;
? the Tribunal did not find the order imposing the condition in paragraph 1 should automatically expire in 3 years (as with other conditions imposed). This is indicative the Tribunal thought a review by a Tribunal after a minimum period of three years would be appropriate;
? the powers available to the Tribunal in conducting the review include the power to issue summons for production of documents or the calling of witnesses;
? the fact the Council was not the decision making entity who made the . the subject of the review;
? the ability of the Tribunal to inquire and determine whether the nurse was psychologically able to cope at the time of her infant son?s tragic and untimely death without resort to illicit drugs or that she abused prescription drugs at about that time. If not, whether there is presently an ongoing concern about past or potential drug addiction noting that the review is to determine, at the time of the review, the appropriateness of the order concerned.

I have balanced the above factors with the following matters:

? the costs involved for the nurse, the relevant bodies and the public in a review hearing before the Tribunal compared to those before a Council;
? the assertion the matter may be dealt with in a more timely way by the Council rather than the Tribunal.

Discussion and findings

33. As I noted in Marks, Coe and McAuley: ?Section 163(1)(a1) does not set out any criteria to be take into consideration in determining if the Council, or the Tribunal, is the appropriate review body. In other words, the determination of the appropriate review body is a matter of discretion, which must be exercised judicially, having regard to the underlying factual matrix?.

34. In this case I have placed weight on the following matters. First, the original hearing which dealt with the Complaint brought by the HCCC was heard and determined by the Committee, not by the former Tribunal. Notwithstanding that fact, as the reprimand imposed at the conclusion of the hearing demonstrates, the issues of inappropriate or inadequate appropriate professional care of Patient A by the applicant raised in the Complaint were very serious ones.

35. Second, the evidence provided by the applicant demonstrates that during the period from 2008 to date she has been in regular contact with the Board and since 2010 with the Council in its role as successor of the Board. She has responded to correspondence and requirements of the Council. The Council has effectively monitored the conditions imposed in the orders including contact with both the applicant and her employer. The relationship between the Council and the applicant, on the material before me, discloses a very appropriate professional role undertaken by the Council in monitoring the conditions imposed by the orders, and also an appropriate professional attitude to compliance by the applicant. In short, the Council has been actively involved with the applicant and has relevant and up to date knowledge of her circumstances, including her employment history, mentoring relationship, and compliance with the conditions.

36. Third, it is appropriate for the review of conditions imposed by the orders to be considered in a timely manner. Because of the Council?s active involvement to date in supervising the conditions, it is uniquely placed to deal with the review in a timely way and in a manner proportionate to the matters now in issue. This is a particularly relevant factor given the evidence of the courses undertaken by the applicant, her compliance with the conditions, her work history since 2008 and the time which has elapsed since the complaint was determined.

37. Fourth, the costs to all parties, and the Tribunal will be minimised if the Council is the appropriate review body.

38. Finally, I have taken into account this matter was determined by the Committee prior to the introduction of the National Law. As I discussed in McAuley the need in future years for applications such as the instant one, will be avoided by a Council, Performance Review Panel or Committee nominating in relevant orders the appropriate review body to undertake the review of any order imposing conditions.

39. I have also placed weight on the fact that the Council, and the HCCC, do not oppose the Council being the appropriate review body.

40. Taking each of the considerations enunciated above in account, I am satisfied on the evidence before me, that the Council should be the review body.


 

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