Monday, December 30, 2019
Skills And Knowledge Of Employee Training - 979 Words
Employee training is essential to the organization because it helps the employees improve their performance. Secondly, excellent employee performance helps the organizationââ¬â¢s success. It is very important that the management provide necessary training to those employees who needs improvement. In order to determine the need of employee training, the management must provide several steps. This includes, conducting analysis, establishing goals and objectives. To determined the need of employee training, the first step is to conduct an analysis as to what type of training that will be needed, to improve the employeeââ¬â¢s performance. For example, if the employees need a task analysis such as using a register, it is important to identify how each employee are performing while using the register. Before I provide a task training, I can observe and conduct every transactionââ¬â¢s errors. This will determine the skills and knowledge of the employees while using the register. â â¬Å"Skill test is a test that measures an employees level of some job related skills. Knowledge test is a test that measures the level of an employeeââ¬â¢s knowledge about a job related topic.â⬠During my research, I can identify errors from transactions and I can observe the employeeââ¬â¢s strength and weaknesses. (Aamodt, 2015, p. 288) Once I finished with my observation and research, the next step is to develop a training program for those employees that is having difficulty with their task performance. The next step afterShow MoreRelatedEmployee Development : An Organization1164 Words à |à 5 PagesEmployee development is a constant effort by an organization to improve and develop the skills, knowledge and abilities of its employees. Global change and advancement in technology have generated knowledge to sustain competitive advantage of a company. 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Training implies constructive development in such organizational motives for optimumRead MoreTraining Increases Job Skills While Development Shapes Attitudes Essay1108 Words à |à 5 PagesRESEARCH ASSIGNMENT ASSIGNMENT 2:- Training increases job skills while development shapes attitudes in the light of this statement explain the relationship between training and development by giving insights of advantages of training development. Ã¢â¬Æ' INTRODUCTION In growing complex corporate world it becomes important for any business firm whether small or large to be ready for future. Any business or organization canââ¬â¢t work unit they donââ¬â¢t have a strongRead MoreEmployee Training and Career Development1147 Words à |à 5 PagesEmployee Training and Career Development HRM/300 July 23, 2012 Employee Training and Career Development Employee training and career development programs are an essential function of a human resources department. 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Yet others may feel evaluations will threaten theirRead MoreBeer School993 Word s à |à 4 Pagesbeer school, suggestions are mentioned below: Organization Level: For the effectiveness of this training program, organization has already streamlined the training with its business strategy. Companyââ¬â¢s mission, vision, values and beliefs are communicated well at every level in the organization especially with human resource strategies such as this training program; rather made it a strategic training. à After careful consideration have given to internal and external environment and assessment of companyââ¬â¢sRead MoreTraining Policy : Training And Development1496 Words à |à 6 PagesTraining Policy It is Motors and Moreââ¬â¢s intent that all training that employees receive to â⬠achieve development of skills, knowledge, and abilities will be related to their job duties and developmentâ⬠(Washington State University). Human resources will implement the necessary training programs that will ensure the focus is primarily on individual and organization development. Training shall provide for the following: 1. Establish a system within Motors and More that will ensure funds are providedRead MoreEmployee Training and Development Paper1057 Words à |à 5 PagesAbstract Employee Training and Development Paper Employee training and development is very important in organizations. Development, orienting, and socializing will help employees get to know their new organization. New employees will go to a process that will help them adapt to their new organization. Employee orientation will be the responsibility of human resources management, and this will depend on the organization. During this process the employees would get information on the work hoursRead MoreTraining and Development784 Words à |à 4 PagesTRAINING AND DEVELOPMENT ââ¬Å"Training and development refers to the imparting of specific skills,abilities and knowledge to an employee.â⬠Training and development is any attempt to improve current or future employee performance by increasing an employeeââ¬â¢s ability to perform through learning,usually by changing the employeeââ¬â¢s attitude or increasing his or her skills and knowledge. WHAT IS TRAINING ? Training is concerned with imparting developing specific skills for a particular purpose.Traning isRead MoreTraining And Development For Employees1008 Words à |à 5 PagesIntroduction For Staff or employees training is essential for specific purposes related to business. Incorporating training that develops employees towards long-term career goals can also promote greater job satisfaction. A more satisfied employee is likely to stay longer and be more productive while on term. Carter author there are numerous sources of online information about training and development for supervisors to conduct training among workers. These reasons include, Increased job satisfaction
Sunday, December 22, 2019
Summary Of The Night I m Sitting - 1473 Words
I shouldnââ¬â¢t have even been in. Any good coach knows to pull out the star in a blowout. Iââ¬â¢m not sure what coach was thinking at the time... but nevermind. Thatââ¬â¢s the past, and I canââ¬â¢t reverse it. Still, I canââ¬â¢t help going back and thinking about that fateful day. Today at lunch Iââ¬â¢m sitting in Mr. Andersonââ¬â¢s empty classroom studying. A month ago, I would be sitting in the middle of the lunchroom with Derek, Mike, Rakim, and the rest of the team. A month ago, I would still be the king of this school. Exactly 32 days ago, my team, the South Heights Cardinals were in Parkside to play the lowly Parkside Panthers. They were in last place in the conference with only one win, and we were undefeated at the top of the standings. Everybody knewâ⬠¦show more contentâ⬠¦I took the court for the beginning of the game. I looked around the court and saw what a mismatch it was. We had more talent than them at every single position. Maybe this was the game that I could get the conference scoring record I had been chasing. Derek, at 6ââ¬â¢10â⬠, a good 5 inches taller than the Panthers center, won the opening tip off and tapped it back to Mike. I recognized that there was nobody near the basket, so I sprinted down the court. Mike tossed it up to me and I threw down a thunderous dunk. The game continued in the direction of a rout and midway through the fourth quarter we lead 71-42. This was the time coach would normally pull out all of the starters and put in all the backups and third stringers. However, I was ten points away from breaking the career conference scoring record. Coach knew that I could definitely break the record, so he left me in. I made a few more baskets and was only a couple points away from the record. Parkside had put in their backups, so I knew I could blow by the guy guarding me. I took one dribble to my left and did a lightning quick crossover to my right, dusting the Panthers point guard. The Parkside team was very frustrated that we were humiliating them, so I guess they wanted to take it out on me. The burly Panthers center hit me hard as I went up for the layup, definitely a technical foul. I went flying and smashed my head on the floor. I hit my head directly on the
Saturday, December 14, 2019
Neoclassical Age Free Essays
The 18th century is a distinguishing period in British literature. It is a timeline in which classical literary conventions in terms of the literary techniques in different genres are revived. After the Renaissanceââ¬âa period of exploration and expansivenessââ¬âcame a reaction in the direction of order and restraint. We will write a custom essay sample on Neoclassical Age or any similar topic only for you Order Now Generally speaking, this reaction developed in France in the mid-seventeenth century and in England thirty years later; and it dominated European literature until the last part of the eighteenth century. It is a period where counterfeiting and facades are very important; in some ways the country was trying to act like the Interregnum and English civil wars had not happened, and there is both a willful suppression of the immediate past and a glorification of the more distant, classical Roman pastââ¬âwhich is why it is called the Neoclassical period. Neoclassical writers, such as Samuel Johnson, Moliere and Alexander Pope, sought clear, precise language. They standardized spelling and grammar, shifted away from the complex metaphors employed by Shakespeare and simplified literary structures. Neoclassical writers often adopted a rigid view toward society. Although Renaissance writers were fascinated by rebels and the Romantics later idealized them, neoclassical writers felt that the individual should conform to social norms. Although society was probably corrupt, individual views could not stand against the truths found in the consensus of society. Principals of Neoclassic Age in Alexander Popeââ¬â¢s ââ¬Å"essay on manâ⬠There are many concepts regarding literary criticism that are instantiated in the first part of Popeââ¬â¢s Essay: the problem of bad writing and criticism, and the greater danger of the latter to the public; the rarity of genius and taste in poets and critics respectively; the impairing of the capacity of critical judgment by unsound education; the causes for the multitude of literary critics (those who canââ¬â¢t write, judge! ; and the critics need to know the limits of his genius, taste, and learning in the exercise of criticism. What is the basis for literary composition and the practice of criticism? What provides the common ground and gives guidance for both? For Pope, the answer was found in a specific eighteenth century understanding of the honorific term and concept of NATURE. First follow Nature and your judgment frame By her just standard, which is still the same: Unerring NATURE, still divinely bright, One clear, unchanged, and universal light, Life, force, beauty, must to all impart, At once the source, and end, and test of Art. (Lines 68-73) Nature is the ultimate authority (Williams 219) in Popeââ¬â¢s Essay, and is presented here as that canon or standard to which both with (creative poetic and literary expression) and critical judgment are to conform. Authors and critics are to write and to judge according to the clear, unchanged, and universal light just standards of inerrant Nature. In literature and criticism, Nature is all-significant as its source, as its aim, and as its test. Art is from Nature, unto Nature, and by Nature. But what, exactly, does Pope mean by this all-encompassing concept? Williams expresses the eighteenth-century, neo-classical understanding of this doctrine in these terms. Fundamental to neo-classical thought about Nature is the conception of a cosmos which, in its order and regularity and harmony, reflects the order and harmony of the Divine Mind of its Creator. . . Man can perceive this order and rule in Nature because he has a rational soul made in the image of that Natureââ¬â¢s Creator. . . . In the view which prevails in the period Nature is the manifestation in the visible creation of the Order and Reason behind all things, a reflection of the medieval view that the likeness of God is imprinted in the very matter and organization of the universe (219-20). In concluding Part One of his Essay, Pope is so taken with the natural goodn ess of the primeval authors that he has difficulty restraining himself in declaring their praise. The religious nature of their veneration is not only transparent, but also significant literarily. Here in worship before a common altar, divisions and sects and quarrels in criticism are forgotten as men unite in a single congregation. The learned from all climes and ages bring . . . their incense to a common shrine . . . . Popeââ¬â¢s verse . . . rises in full response to the inspiration his age received from a glorious past, a past which was both an inspiration, and a reproach, to the present (Williams 229). Creation, fall, redemption: this basic biblical schema provides the paradigm for Alexander Popeââ¬â¢s An Essay on Criticism. Just as the focus of the biblical narrative is on the salvaging of a sin-wrecked creation, so the movement of Alexander Popeââ¬â¢s Essay on Criticism is toward the restoration of a fallen classical poetics for eighteenth century England. This parallel supplies substance and shape to the Essayââ¬â¢s grand purpose and 13 design. And in both the Scriptures and in Pope, the goals of cosmic and poetic restoration are ones for which we can and must give thanks. Neoclassicism replaced the Renaissance view of man as an inherently good being capable of astounding intellectual growth by the image of man as a sinful and presumptuous creature with a limited intellectual capacity. Whereas the Renaissance had emphasized imagination and mysticism, Neoclasscisim emphasized order, reason, common sense, and conservatism. Theà widely used prose literary forms were the essay, the letter, the satire, the parody, the burlesque, and the moral fable; andà in poetry, theà most renownà verse form was the rhymed couplet. Popeââ¬â¢s heroic couplets are a prime example of this form. As reason should guide human individuals and societies, it should also direct artistic creation. Neoclassical art is not meant to seem a spontaneous outpouring of emotion or imagination. Emotion appears, of course; but it is consciously controlled. A work of art should be logically organized and should advocate rational norms. The Misanthrope, for example, is focused on its theme more consistently than are any of Shakespeareââ¬â¢s plays. Its hero and his society are judged according to their conformity or lack of conformity to Reason, and its ideal, voiced by Philinte, is the reasonable one of the golden mean. The cool rationality and control characteristic of neoclassical art fostered wit, equally evident in the regular couplets of Moliere and the balanced sentences of Austen. Sharp and brilliant wit, produced within the clearly defined ideals of neoclassical art, and focused on people in their social context, make this perhaps the worldââ¬â¢s greatest age of comedy and satire. How to cite Neoclassical Age, Papers
Friday, December 6, 2019
Company Law for Doctrine of Capital Maintenance
Question: Discuss about the Company Law for Doctrine of Capital Maintenance Answer: Introduction The doctrine of Capital maintenance is the fundamental principle in the corporate law. The main aim for the establishment of this principle is to provide protection to the creditors of the Company (Ewang 2005). The share capital of the Company is protected to give protection to the creditors. The main aim of the principle is: Firstly, the capital which has been raised by the Company is used solely for the carrying out of the business of the Company, discharge liabilities and for the payment of the creditors of the Company; and Secondly, The Company Obtains the Capital Raised by the Company (Hannigan 2015). The capital of the Company is not to be used to repay back the members of the Company except in certain limited situations. The doctrine protects the share capital of the company for the protection of the creditors of the company (Fisher 1896). Many judicial interpretations led to the development of the doctrine. The Doctrine was mainly developed in the case of Trevor v Whitworth (1887) it was held that the Company will not be liable to buy back the shares. The Company had almost bought back the entire shares of the Company. After the Company went into liquidation one of the shareholder of the Company asked for the amount which was due to him (Hannigan 2015). The amount was to be paid back to him after the buyback of the shares of the company. The Court held that the Company is to payback the shareholder his due amount. The House of Lords in his judgment said that the company does not have the right to buy its own shares even if there is criteria mentioned in the memorandum of associ ation of the Company (Arnold 2016). The rule is so because that would reduce the share capital of the company. Where is has not been expressly implied by the Court that there can be a reduction in the capital the company cannot reduce the share capital of the company (Hayek 1936). Provisions such as buyback of share capital, payment of the dividends or reduction for capital are mentioned in Section 17, 18 and 19 of the Act (Islam 2015). In Australia, the development of the Doctrine is enshrined under Section 256 A and 256 C of the Australian Corporation Act 2001. Reduction of share capital of the Company by the creditors is mentioned under Section 256 B of the Company. Australia is a country that receives funding from offshore for the capital infrastructural projects. The Corporation Act of Australia mainly handles the transactions, which affect the share capital of the Company and how the creditors are to be protected. Section 256 C and Section 257 A also lays down the exceptions t o the doctrine (Knapp 2013). It lays down how the company can reduce the share capital and buy back its share. In the case of Flitcrofts Case, the attributes of the Doctrine was established. The traditional capital system was replaced by a transparent and effective system. The creditors of the company are are given a more accurate information about the ability of the company to pay the debts and protect the creditors (Tomasic, R., 2015) . Therefore it can be concluded that doctrine provide protection to the creditors of the company and several amendments were also made to make the doctrine more effective still more cost effective provisions must be made to provide legal protection to the creditors. For the running of a business, smoothly the Australian Corporation law must be made more flexible and effective (Sappideen 2016). References: Arnold, A.J., 2016. Capital reduction case law decisions and the development of the capital maintenance doctrine in late-nineteenth-century England.Accounting and Business Research, pp.1-19. Ewang, F.N., 2005.The Capital Maintenance Doctrine Provides Essential Protection to Corporate Creditors: Myth Or Reality?. University of Adelaide, Law School. Fisher, I., 1896. What is capital?.The Economic Journal,6(24), pp.509-534. Hannigan, B., 2015.Company law. Oxford University Press, USA. Hayek, F.V., 1936. The mythology of capital.The Quarterly Journal of Economics, pp.199-228. Islam, M.S., 2015. The Doctrine of Capital Maintenance and its Statutory Developments: An Analysis.Northern University Journal of Law,4, pp.47-55. Knapp, J., 2013. A Reconsideration of Consolidation Accounting Requirements and Pre?acquisition Dividends.Australian Accounting Review,23(3), pp.190-207. Sappideen, R., 2016. Reflections on Changes to China's Corporate Capital Law. Tomasic, R., 2015. The Rise and Fall of the Capital Maintenance Doctrine in Australian Corporate Law. Tsang, A.H., 2000.Maintenance performance management in capital intensive organizations(Doctoral dissertation, University of Toronto).
Thursday, November 28, 2019
There are many people that think that Odysseus isn Essays
There are many people that think that Odysseus isn't heroic because he got all of his crew men killed durin g their return trip to Ithaca. He has lied to them and even initiated a series of bad luck towards him and his men. But there's also many others people that think he is the most heroic person, because he saved his men from different problems they faced during the jou r ney. Odysseus was heroic because through two creatures he defeated them. The creatures were the Cyclops and Polyphemus son of Poseidon and at the land of the dead. Odysseus and his men are in the cave of Polyphemus eating all of his expecting him to obey the Greek hospitality. Instead of being okay with it Polyphemus eats two of Odysseus' men. Odysseus tells Poyphemus that his name is "Nobody". If only the men could get but there is a big obstacle in their way a huge boulder, that Polyphemus can move out of the way. Ody s seus has prayed to Athena the goddess of wisdom to help him figure something. An olive branch appears enabling the men to create a spear and blind Polyphemus. The men have the Cyclops get drunk enough that he will fall asleep and stab him with spear, now all they have to do is figure out how to get out of the cave.
Monday, November 25, 2019
Mobility in stroke rehabilitation Essays
Mobility in stroke rehabilitation Essays Mobility in stroke rehabilitation Essay Mobility in stroke rehabilitation Essay Mobility in stroke rehabilitation BY Itsas0101289 Mobility in Stroke Rehabilitation The purpose of this assignment is to identify the nursing role in the mobility rehabilitation of a patient who had a lacunar ischaemic stroke affecting the right corona radiata. The nursing care and the interdisciplinary management of the impairment will be critically evaluated as well as the patient progress during the stay in the hospital. The patient that will be discussed in this assignment was given the pseudonym of Martha. Martha is a 76 year old female who had a lacunar ischaemic stroke of the ight corona radiata. She has relevant past medical history of hypertension. on admission, Martha was presented with weakness on her left side in both her leg and arm with sensation preserved and no cognitive impairments. The corona radiata is a white matter that contains both descending and ascending axons that carry information from and to the brain cells that make up the cerebral cortex, an area of the brain that is responsible for the processing of conscious information and where the orders to initiate voluntary movements (walking, tapping your foot) first originate (Similima, 2011). These areas of the nervous system activate muscles all over the body to move. Therefore if the corona radiata is affected by a stroke, movement will be interrupted. The type of stroke that affects the corona radiata is called Pure motor stroke and is the most common type of lacunar strokes, accounting for more than 50% of all cases (Similima, 2011). Pure motor strokes cause partial or complete weakness in the face, arm and leg on one side of the body. It can occur in any of these areas, alone or in combination with either of the other two. Most commonly, pure motor strokes cause either a combination of arm and leg eakness, sparing the face (this is the case of Martha), or a combination of arm, leg and face weakness. By definition, there is no loss of sensation anywhere in the body, no visual or speech symptoms or higher cognitive impairment (Wityk and Llinas, 2007). The hemiplegia is one of the most common neurological impairments following stroke and it needs to be managed by every member of the medical team all patients have the benefit of the range of expert advice needed for high quality care (NHS, 2010). Multidisciplinary teams (MDT) need to bring together staff with the ecessary knowledge, skills and experience to ensure high quality diagnosis, treatment and care. The MDT meeting is about considering the patients individual case not Just about treating a stroke. To support this, an MDT should take account of the patients views, preferences and circumstances wherever possible when consulting on the care that is most appropriate for the patients condition. MDTs should be alerted if there are significant changes to their recommendations and the reason for this is so they have the opportunity to review and build upon each case The aim of the Multidisciplinary approach to a patient who suffers from a motor impairment is to maximise functional ability by providing time, space for activities, aids and equipment, preventing injury and promoting safety (Woodward and Mestecky, 2011). When caring for a patient it is of the utmost importance to ensure there is no further injury, therefore the communication within the team is crucial. Every member of the team should know what the patient is able to do and how they should be cared for to gain the best rehabilitation. Marthas case was approached this way and her status was discussed twice daily in the handover. Also during the day it is the nurses duty to speak the physiotherapist and get her recommendations. When possible, I found very helpful going with the physiotherapist and doing the daily exercises together enabling me to get a better understanding of Marthas condition and Martha seemed to like the added support. This also gave Martha more confidence around me when doing transfers as sometimes it can be very scary for a patient trying to mobilise when suffering from hemiplegia. Along this the Multidisciplinary meetings were done twice a week with the consultant, the hysiotherapist, the occupational therapist, the ward sister and myself or the nurse who was on duty looking after Martha. Correct positioning and early mobilisation of a patient following stroke is important in preventing potential complications arising from impaired movement which can develope changes in muscle tone such as spasticity. Around 19% of patients suffer spasticity following a stroke associated with pain and which interferes with rehabilitation interventions (Woodward and Mestecky, 2011). On admission the physiotherapist performed the Modified Ashworth Scale and Martha scored 1 which eans that there was slight increase in muscle tone. This was manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension (Bohannon and Smith, 1987) (Woodward and Mestecky, 2011). From the beginning Martha used to hate being in bed and after being assessed by the physiotherapist making sure she was safe to do so she used to spent most of the time sitting in the chair provided. She was educated to sit well back and in the centre of the chair placing the affected arm well forward n a pillow with the feet flat on floor and knees directly above the feet. She was very comfortable in that position and she always had the nursing bell close to her and used to call us if the pillow fell down or when similar issues arose. However, there were times that Martha was feeling tired and she had to spent longer periods resting. While in bed she usually prefer lying on her affected side so she could be more independent. She liked having two pillows for the head and the affected shoulder was moved well forward placing the good leg forward on a pillow and another pillow placed behind her back. Although her preference was lying on the affected side, after being educated of the complications of immobility she didnt have any problem to lie on the non affected side, especially during the night. The affected shoulder was placed forward with arm on pillow and the affected leg backward on a pillow. Plus an extra pillow was also placed behind her back. Another action taken postulated to be secondary to promotion of anti-gravity muscle activity in the trunk and lower limbs, maintenance or improvement in soft tissue and Joint flexibility, modulation of the neural component of spasticity through prolonged stretch and ltered sensory input, reduction of lower limb spasms and positive psychological effect (Stevenson VL, 2010). At the beginning this was Just carried out by the physiotherapist with the nurses help for safety reasons. Active movements were also performed to increase strength, re-educate movement patterns and improve cardiovascular fitness. Active movements should be encouraged because the effects are greater than those seen with passive exercise alone. These benefits have been seen in studies of people suffering from a stroke (Stevenson VL, 2010). Marthas rogress was incredible and when she left the hospital she was able to walk with a walking stick and the supervision of her daughter or with a zimmer frame and the Modified Ashworth Scale score was O. This was an achievement as when she came she wasnt able to mobilise at all. Another complication that can occur as a consequence of having a mobility reduction is the damage of the skin integrity therefore several tools were done to assess this risk. Within the first 6 hours of admission every patient needs to be assessed using the waterlow assessment and the MUST nutritional screening, also the skin needs to be inspected. Martha got a waterlow score of 17 on admission which placed her at high risk of developing a pressure sore, she was continent of faeces and urine and no pressure sore was found on admission. The taken actions according to NICE guidelines 2005 were to provide her an air mattress, to place her in a position chart ensuring that the prolonged pressure on bony prominences was minimised and ensuring the correct usage of manual handling devices in order to minimise shear and friction damage. Two sliding sheets were provided and the bony prominences were kept from direct contact from one another by using pillows in between them. At the beginning Martha found very difficult to get used to sleep on an air mattress because of the noise but the benefits of using it were explained and she agreed to use it. By talking to her I discovered that she loved listening to music when she was going to sleep and the following day when her family came to visit her, the difficulty of sleeping because of this device was discussed and they brought Marthas iPod with her favourite music which helped her to sleep peacefully through the night. Having a good night sleep is very important for any patient, specially for those who re having rehabilitation as they require a lot energy and strength. Additionally skin inspections were done regularly and Martha, as she wasnt mentally impaired was taught how to inspect her skin. She was shown what the high risk areas were (heels, sacrum, ischial tuberosities, elbows, temporal region of skull, shoulders, back of head and toes) and early signs of skin integrity deterioration (persistent erythema, non- blanching erythema, blisters, discolouration, localised heat, localised oedema and localised induration) (NDNQI, 2013). Regarding general hygiene, Martha required assistance due to her mobility impairment. Such care was provided regularly according to the RCN guidelines that recommends that skin cleansing should be done with mild detergents using warm water to minimise irritation and drying and particularly over bony prominences should be avoided (RCN, 2009). Martha was always very helpful and used to do as much as she could by herself, at the beginning she required more assistance but by the end of her time at the hospital we Just needed to supervise her when going to the shower and she used to do everything by herself. She usually liked to have her shower after the physiotherapist session and his preference was respected as much as possible. Also she didnt like to use the hospital clothes which according to her made her look less sick so the family brought her own clothes. The MUST score obtained was 1 on admission. Adequate nutrition is required by the body for maintaining tissue integrity and preventing tissue breakdown (NPUAP,2009) Due to this score Martha was put on food chart which helped us monitoring her food intake along with daily weight measurements and she was also referred to the dietician on the day of admission who put her on food supplements and which were discontinued when Martha started having a etter food intake. The family was made aware of the importance of having a good food intake and they brought Martha her favourite cakes and homemade food. At the beginning Martha needed assistance with feeding herself as she wasnt able to cut her food, opening leads etc. Assistance was given regularly and the kitchen staff was made aware about her requirements, therefore before serving her food they always used to come and talk to us first as it can be very frustrating not being able to feed yourself and have the food in front of you. Martha had a good progression during her tage in the hospital and she put on 3kg, her food intake was appropriate and she didnt develop any pressure ulcer. When the mobility of a patient is reduced the risk of VTE (Venous Thromboembolism) increases and therefore in a patient who suffers from hemiplegia after stroke should be assessed for this risk and preventive measurements should take place. According to The National Institute for Clinical Excellence (NICE, 2010), recommendations are that all patients should be assessed for risk of developing thrombosis (blood clots) on a regular basis. Martha was assessed on admission scoring 8 using the adapted tool rom Autar 2003 (Version 2PT 5/12) She was assessed again 24 hours after admission and when her mobility was better she was reassessed scoring 5. Because of the risk of developing a WE Martha was put on Enoxaparin and all the effects and risks were explained. Current NICE guidance suggests LMWH (Low Molecular Weight Heparin) prophylaxis for acute medical patients at WE risk unless there is a high bleeding risk (NHS, 2012). Stockings were not put on her because according to the Clots in Legs or Stockings after Stroke (CLOTS) trial 1 GECS (can even present a greater risk to patients f skin breaks, blisters, ulcers and skin necrosis (CLOTS Trial Collaboration, 2009). Early mobilisation is fundamental to prevent WE along with more risks and that is why this patient was mobilised as soon as possible with the physiotherapist support (NICE, 2010). A very weak arm due to its considerable hanging weight, is at risk of stretching the shoulder Joint structures and developing a partial dislocation or subluxation (Turner- Stokes and Jackson, 2002). Shoulder subluxation is considered a problem because it Many studies have suggested that trauma to the shoulder Joint can be prevented by roper positioning and handling. The shoulder should be protracted, the arm forward, the wrist in neutral or slight supination and the fingers extended. Another important aspect that needs to be considered is not to pull from limbs when doing transfers, especially from the affected one. Therefore Martha and family were educated not to do so. An arm sling was provided to her to support the affected arm. However,the sling was only used while doing transfer. When she was sitting on the chair a lap tray was provided positioning the arm away from the body, discouraging dduction and internal rotation and allowing bilateral upper limb activities (Turner and Jackson, 2002). Martha didnt develop a shoulder subluxation during her stage in the hospital. This was confirmed by an X-Ray that was taken to ensure there was no underlying problems. However she had pain on the shoulder and that is why this X- Ray was performed initially. Hemiplegic shoulder pain, or post stroke shoulder pain, occurs in at least 30 percent of patients although another estimate placed it at 70 percent . Post stroke shoulder pain can adversely affect both length of in patient ehabilitation and overall functional outcome (Woodward and Mestecky, 2011). Martha was on regular paracetamol but she wasnt put on NSAlDs from the beginning. When she started to feel this pain the consultant was informed who requested an X-Ray, the physiotherapist and the rest of the team were also made aware of the troubles. The consultant also put the patient on PRN Ibuprofen which was very effective in reducing the pain levels. I consider that the approach to this risk wasnt the most effective one as Martha suffered from shoulder pain and it can be an area to improve for future patients. However the communication within the team was very successful and the problem was solved in a short period of time. Another recommendation for the future supported by evidence based documentation could be the practice of passive movements which improve the spasticity (Lynch, et al. 005). After suffering a stroke the person can suffer an alteration on the body image understanding as such as the beliefs and feelings about how our bodies look and function. This is influenced by what we think we should look like, and how we think our bodies should perform. In Marthas case the main issue for her was the loss of unctionality of half of her body. Martha went from being able to perform all the activities of the daily life by h erself to require assistance for most of them. Successful adjustment and adaptation to this new situation depend on how well the acquirement of the new knowledge is and skills needed in order to get on with her life. (Woodward and Mestecky, 2011). The rehabilitation team role was crucial here because we needed to teach her new skills and this was achieved by good coordination and communication within the team. It was very important to proceed in the same way and reinforce the knowledge. As supportive measures a board was used to remind Martha the steps she had to follow and also it was very helpful for her family as they knew which was the appropriate way to help her mother. Also setting realistic goals was very positive for her as every day she had a new challenge to achieve and that kept her motivated. Motivation also plays a vital role in with the way in which a patient evaluates their chances of successful rehabilitation and that this is influenced by social or external factors (Woodward and Mestecky, 2011). Martha as already mentioned was always motivated to improve her skills and his had a very positive impact on her evolution. Also she had a very good support from her family who was always there to help her and a good support from the health team. After 5 weeks of rehabilitation Martha was discharged being able to perform the activities of the daily life by herself, walking with a walking stick and assistance from her daughter or with a zimmer frame. She went to a nursing home for a couple of weeks while they were adjusting her house for her (she lived with her daughter). After she was seen by the team (consultant, physiotherapist) as an outpatient and she also came to visit the team to the ward. Reference list Bader ,M and Littlejohns, L (2004) AANN Core Curriculum for Neuroscience nursing. th edition. Missouri. Saunders Bohannon, R. and Smith, M. (1987). Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy 67(2): 206. Jun Hao Pan, Xin Yuan Song,; Sik Yum Lee, Timothy Kwok, (2008) Longitudinal Analysis of Quality of Life for Stroke Survivors Using Latent Curve Models. Stroke. Lynch, D; Ferraro, M; Krol, j; Trudell, C M; Christos, P and volpe, B T . (2005) Continuous passive motion improv es shoulder Joint integrity following stroke Clinical rehabilitation. Available at: http://cre. agepub. com/content/19/6/594. full. pdf *html (Accessed 9 March 2013) National Institute of Clinical Excellence (2010) Venous thromboembolism reducing the risk: full guideline. Available at: http:// www. nice. org. uk/nicemedia/live/12695/47200/47200. pdf (Accessed 8 March 2013) National Institute of Clinical Excellence (2001) Clinical practise guidelines, Pressure ulcer risk assessment and prevention, recommendations 2001. Available at: http:// www. nice. org. uk/nicemedia/pdf/clinicalguidelinepressuresoreguidancercn. pdf. Accessed: 6 March 2013) National Pressure Ulcer Advisory Panel (NPUAP) (2009) The Role of Nutrition in Pressure Ulcer Prevention and Treatment. Available at: http:// www. npuap. org/wp-content/uploads/2012/03/Nutrition-White-Paper-Website- Version. pdf (Accessed: 25 March 2013) NDNQI (2013) Pressure ulcers training. Available at: https://www. nursingquality. org/NDNQlPressureUlcerTraining/Module1/ Default. aspx (Accessed: 25 March 2013) NHS (2010) CLOTS trial 2: Thigh length versus below knee stockings for DW prophylaxis post stroke. Available at: http:// www. nelm. nhs. /en/NeLM-Area/News/2010September/21 /CLOTS-trial-2-Thigh- length-versus-below-knee-stockings-for-DVT-prophylaxis-post-stroke/ (Accessed: 6 April 2013) NHS (2010) The Characteristics of an Effective Multidisciplinary Team (MDT). Available at: http://ncat. nhs. uk/sites/default/files/ evidence. Available at: evidence. nhs. uk/documents/]-nhs-evidence-comms-publications-eyes-on- evidence-eyes-on-evidence-sleep-apnoea-t hromboprophylaxis-contraception-stroke- diabetes-and-more. pdf (Accessed: 6 April 2013) Royal College of Nursing (2009) RCN Masterclass (2009): Continence, Pressure Ulcers and Nursing Metrics. Available at: rcn. org. uk/_data/assets/pdf_file/0004/280777/Dettorri_M_Collier_ppt. pdf. (Accessed: 25 March 2013) Royal College of Nursing (2013) Preventing VTE. Available at rcn. org. uk/ development/practice/cpd_online_learning/ nice_care_preventing_venousthromboembolism/preventing_vte (Accessed 7 March 2013) Stevenson VL. (2010) Rehabilitation in practice: Spasticity management, Clin Rehabil 2010 24: 293. Available at http://cre. sagepub. com/content/24/4/293. full. pdf *html (Accessed: 7 March 2013) Similima (2011) Corona radiata. Available at: http:// www. similima. m/physiology-biochemistry (Accessed : 6 March 2013) Thompson H and Ryan A (2008) A review of the psychosocial consequences of stroke and their impact on spousal relationships. British Journal of Neuroscience Nursing Vol 4 No 4 pp 177- 184 Turner-Stokes L, Jackson D. Shoulder Pain After Stroke: A Review of the Evidence Base to Inform the Development of an Integrated Care Pathway. Clinical Rehabilitation, 2002: 16: 276-298. Wityk, R and Litnas, R. (2007) stroke. Philadelphia : American College of Physicians Woodward, S. and Mestecky, AM. (2011) Neuroscience Nursing Evidence-Based Practice. Chichester:Blackwell Publishing Ltd.
Thursday, November 21, 2019
List and briefly describe at least five of the programs included with Essay
List and briefly describe at least five of the programs included with Microsoft Office 2010. Provide an example of when you might use each one - Essay Example It is a valuable program for analyzing numerical figures. This program is very helpful in making budget reports, calendars or invoices (Microsoft Corporation, n.d.) The PowerPoint program enables the user to make powerful presentations (Microsoft Corporation, n.d.). It now allows easier coordination with other people through co-authoring which makes it possible for collaborators to work at the same time on one presentation (Microsoft Corporation, n.d.). It is used to make office report presentations and slideshows. This program ââ¬Å"creates professional quality publications and marketing materialsâ⬠(Microsoft Corporation, n.d.). Publisher is a valuable program for making advertising materials, newsletters, greeting cards and brochures. This is the database program of Microsoft Office. It is used to manage and organize information with the use of its templates and other modular components. This program is very useful in setting up a database of a companyââ¬â¢s customers. It is also beneficial for creating database for an organizationââ¬â¢s workforce. Microsoft Corporation. (n.d.). Whats new in PowerPoint 2010? Retrieved February 17, 2012, from Microsoft Corporation Web site: http://office.microsoft.com/en-us/powerpoint-help/what-s-new-in-powerpoint-2010-HA010336563.aspx Microsoft Corporation. (n.d.). Word 2010 features and benefits. Retrieved February 17, 2012, from Microsoft Corporation Web site:
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