Medical Devices in Nursing: Blood Glucose Monitoring Device

Medical Devices in Nursing: Blood Glucose Monitoring Device Melissa Cassar Write a short account of the devices used in your area of practice (200 words) As a reliever nurse at Sir Paul Boffa Hospital, I mainly work at the Dermatology Department which consists of; a Dermatology Ward, Minor Surgery Theatres, Follow-up/ New-cases Clinics with consultants, the Leg Ulcer Clinic, the Phototherapy Unit, Patch testing, Wart Clinics and Skin Tag Clinics. From this sub-department a number of medical devices are used, the most commonly used devices are: Blood pressure machines and stethoscope Used to measure a patient’s blood pressure Blood glucose monitoring machines Determines the approximate concentration of the patient’s glucose in their blood Hand held Doppler Used in the leg ulcer clinic for assessing ankle brachial pressure index of the lower limbs Thermometer A tool that measures and monitors body temperature Scale Used in assessing patient’s weight Measuring tapes Used to measure the surface of a wound Dermatoscope An easy-to-use tool used for examining the skin surface and making measurements of different skin lesions Choose a particular device for detailed study and describe the device and its clinical use (if applicable including interaction of device and ICT) From the above mentioned medical devices, the Blood Glucose Monitor or more commonly known as ‘glucometer’ was chosen. Glucose monitoring has become a major adjunct to the care of individuals with diabetes mellitus in the past decade (Colwell, et al., 1987). Individuals who suffer from diabetes and healthcare professionals are able to check and read blood glucose levels regularly by using these portable lightweight devices. These devices are often used in hospitals to avoid having to wait for laboratory glucose tests as the device returns a blood glucose reading in a matter of seconds. Predominantly, most of my working hours are spent in the Leg Ulcer clinic, where we treat and manage patients who suffer from leg ulcers. Diagnosis is an important factor in leg ulcers as it determines the correct treatment pathway. As stated by the Clinical Practice Guidelines (2006), a full clinical history and physical examination should be conducted on a patient presenting with either their first or recurrent leg ulcer and assessment should be ongoing thereafter. Required laboratory tests, physical examination and clinical history including previous and current blood glucose measuring to check for Diabetes mellitus, assess and determine the patient’s diagnosis revealing the cause of leg ulcer and identify the required treatment needed. Hackett (March 1994), states that most blood glucose monitoring devices consist of glucose test strips and a reflectometer to determine glucose concentrations in whole blood. Some systems depend on a glucose oxidase-colorimetric reaction that occurs when a drop of blood is placed on a reagent-impregnated pad. Hackett also continues that the test pad contains the enzymes glucose oxidase and peroxidase, and color indicators. When whole blood is placed on the test pad, glucose is oxidized to gluconic acid and hydrogen peroxide with glucose oxidase acting as a catalyst. The hydrogen peroxide that results from this reaction oxidizes an oxygen acceptor in the presence of peroxidase to form a color change, the intensity of which is directly proportional to the amount of glucose in the blood sample (Hackett, March 1994). Blood glucose tests are used to measure blood glucose and if blood glucose is high this results in hyperglycemia whereas if blood glucose result is low, hypoglycemia is detected. Screening patients who are at risk of having diabetes is essential as some patients show no early indication or apparent symptoms. This test is essential as a mean to prevent arising complications or deterioration due to an advance level of diabetes. In the Maltese Health-Care system, glucose levels found in blood by the glucose monitoring device are measured in millimoles per liter (mmols). All blood glucose measuring devices are small in size (fit in the palm of your hand) thus making them highly efficient in portability, are battery powered and are assembled together with solid-state electronics making the device robust in case of any accidents by dropping the device. The device’s accuracy is important as not only the patient’s well-being could be in jeopardy but may also result in a patient’s death due to severe undetected hyperglycemia or hypoglycemia. Associated Documentation Title page of the user manual On Call Platinum Blood Glucose Monitoring System Sample output from the device List of persons in charge of device management – If device failure occurs, it is important for nurses to remove the device from service immediately, tag it with a label describing the problem and report the incident to the nurse in charge which will then be escalated by reporting the faulty device to the maintenance within the facility so it can be evaluated and repaired or returned to the manufacturer if required. Existing training procedures for new users – At Sir Paul Boffa Hospital, there are currently no training procedures provided to any new users. The blood glucose monitoring technique is supervised and taught by a mentor to any student nurses during their placements done during their three year course at University of Malta. If one of the new users has never learned how to use the device, an experienced senior nurse shows and explains the procedure to the unskilled nurse and helps the new user master the skill. Analyse critically the specifications of the device (list of specifications can be found in the user manual). There are many different types of blood glucose monitor devices on the market. Each device comes with a unique set of specifications according to the user’s specific need. The blood glucose device used in the Dermatology Out-Patient Department is manufactured by ACON Laboratories, Inc. and is found by the name of ‘On Call Platinum’. One of the features the ‘On Call Platinum’ offers is the measurement range which lies between 0.6 33.3 mmol/L (10 600 mg/dL. If the patient has a mmol/L reading of less than 0.6 or more than 33.3, the device will not be able to return a result. The result calibration feature involves measuring glucose concentrations in plasma and not the whole blood. Glucose levels in plasma are generally 10%–15% higher than glucose measurements in whole blood. The glucose meter uses an equation that has been hardcoded into the device to calculate the plasma equivalent from the whole blood glucose reading. The minimum volume of blood sample needs to be 0.8 ÃŽ ¼L. Devices requiring smaller volume reduces the frequency of unproductive pricks to the patient‘s body. The ‘On Call Platinum’ test time is five seconds. This results in faster, more accurate results and reduces chances for errors. Battery life can serve up to a minimum of 3,000 measurements (without con sidering data transfer and test reminder alarms) and therefore can be used for long term. The device is pre-set to either millimoles per liter (mmol/L) or milligrams per deciliter (mg/dL) depending on the standard of the country it is being used in. Here in Malta, the millimoles per litre (mmol/L) is used. This specific type of blood glucose monitor has a memory storage up to 300 records with time and date and thus is ideal for keeping tracks and records of patients. Another important feature is that the device automatically shuts off in two minutes of no interaction. This type of specification helps in preserving battery life when the device is accidentally left switched on after its last use. The blood glucose meter size is 90mm x 58mm x21mm weighing 66g (with battery included), approximately the size of the palm of the hand therefore making the device light, easier to use and portable. Its display size is 41mm x 37mm with brilliant backlit display making reading the numbers easy anytime, anywhere. The ‘On Call Platinum’ operating temperature ranges between 5 45 à ¢Ã¢â‚¬Å¾Ã†â€™ and its operating humidity ranges between 10-90%. This means that the device operates in most environments. Another specification is that the hematocrit range needs to be between 20%-70% and if the ratio of the volume of red cells to the volume of whole blood (in anemic patients) falls below or is above the required value, it can give false glucose measurements. With the data port feature it allows information from the machine to be loaded easily on most computers using a USB cable. The device also has a strip ejector which allows easy strip disposal for the safety of the user. Last by not least, the ‘On Call Platinum’ also has an advanced testing feature of ketone, hypo and hyper warnings alert for each necessary action. Identify any physical and chemical agents associated with the device, and list precautions for patient and user safety, scrutinize the user manual to identify any physical and chemical agents impacting the effectiveness of the device. As stated by WorkSafe Services (March 7, 2014), a chemical agent is a term used to describe all chemical elements and compounds in a natural state or in a processed state and their by-products, the exposure to which insufficient quantities and duration may result in illness or injury to human health. In addition, WorkSafe Services (March 7, 2014), also states that physical agent is a term used to describe energies, the exposures to which insufficient quantities and duration may result in illness or injury to human health. Physical agents include noise, ionizing or non-ionizing radiation, extremes in temperature and pressure, vibration, electric and magnetic fields. In regards to the blood glucose monitor, factors that affect accuracy include test strip problems. To prevent this, strips need to be stored in their sealed container, kept away from moisture, humidity and heat. Extreme temperatures and altitude may diminish the effectiveness on the glucose meter and test strips so it is important to keep the device and its accessories at room temperature. Alcohol, dirt or any other substances on the patient’s skin will give a false reading. The patient’s hands (or the area which is going to be pricked) needs to be washed and air dried thoroughly before lanced. Improper coding is also a factor that affects accuracy. The user must make sure that the code number in the blood glucose devices matches the code number on the test strip bottle. The monitor can also give problems. The user needs to make sure that the test strips are fully inserted into the monitor and the monitor batteries need replacement if required. Not applying enough blood to the test strip is another factor that impacts the device from giving the correct result. To elude this, the user needs to be sure to apply a substantial drop of blood to the test strip. Sources of strong electromagnetic radiation are to be avoided as they may interfere with the devices’ operation giving an inaccurate reading. To acquire a very accurate reading the blood glucose sampling should be obtained from a fingertip as samples from alternate body parts have a probability to return an inaccurate result. Finally, if the patient is anaemic or dehydrated, there is a high probability of a less precise result. Scrutinize the user manual and list what checks must be carried out to ensure that the device is working properly before being used with patients. Glucometer controls are performance tests that are to be completed on the glucose meter, to ensure that the device is functioning properly. As instructed by Vickery Beinhaker (2012), the quality control process allows users to monitor the â€Å"variables† of blood glucose testing in order to consistently obtain reliable test results. It is highly recommended that this test should be done when a test strip container has been opened for a period of time, whenever a new container of test strips has been opened or when there is a possibility that test strips have been damaged. If the device is dropped, suspected that it is not working properly or the machine is repeatedly giving unexpected blood sugar results, it is important to ensure that such procedure is carried out. Moreover, once a week, there should be a routinely check-up to make sure that the device is working properly and to its full potential. With the blood glucose machine kit comes a control solution bottle. A control test consists of first shaking the control solution bottle for the glucose solution to be distributed evenly. Then, a test strip should be inserted into the meter for the machine to be switched on. A drop of control solution is to be applied to the test strip and the reading is then shown on the display. The given result needs to then be compared with the acceptable test range identified on the control solution package. If the value obtained is within the given range, the blood glucose machine is fully functional. Write a step-by-step protocol for the effective and safe use of the device (i.e., ensuring the purpose in using the device is achieved, that the device is used with patient and user safety in mind and checked before use). Include images of each step. Explain the procedure to patient and gain verbal consent. Collect the needed items to perform the procedure, that include alcohol wipes, a pair of gloves, single-use lancet (preferably auto disabling), blood glucose meter and test strip, band aids, sharps container and gauze swabs or cotton wool. Take the items to the patients’ area or to a suitable procedure area. This procedure should not be carried out in any common areas and the needed items should be preferably transported on a trolley and not inside any pockets. Assess the patient’s allergies (i.e.: latex sensitivity) and verify the patient’s identity using the two of the following unique identifiers: Patients first and last name and their ID card number. This procedure should be performed on a solid surface that can be cleaned and properly disinfected in the event of any blood contamination. Perform correct hand hygiene by washing your hands with soap and water or else by using an alcohol-based hand sanitizer. It is also important to tell the patient to wash the site from which you are going to draw blood with soap and water. Alcohol wipes must not be used on the patient as this may give a false blood glucose reading (Burden, 2001) Put on a pair of gloves and insert the prepared test strip into the blood glucose meter. Wait for the signal on the blood glucose meter to tell you to put the drop of blood on the strip. Normally the blood areaglucose meter gives you a symbol, such as a sign that resembles a drop of liquid. Prick the patient using the single-use lancet. After, immediately discard the used sharps in an approved sharps container. Wipe off the first drop of blood as it could be contaminated. Draw and place the second drop of blood on the test strip. Wait until a result is shown on the blood glucose monitor. The meter will initiate a countdown sequence once the blood is applied to the strip and the meter detects it. The meter will beep or sound an alarm, when a reading is generated. While still wearing gloves, complete the procedure by detaching the test strip from the blood glucose meter and disposing of it in a sharps container. Apply a cotton wool to the pricked area and advice the patient to keep in place in order to stop the bleeding. Remove gloves and place them in the appropriate trash container. Perform correct hand hygiene by using an alcohol-based hand sanitizer or washing your hands with soap and water. Ensure the blood glucose meter is properly cleaned and disinfected after use according to the manufacturer’s recommendations and store the machine appropriately (i.e., in a storage case). Supply proof of own competence signed testimony of local person responsible for training confirming that s/he has observed you using the device and that you are competent in using the device effectively and safely and can check the device before use. Write a short account of (a) the patient perspective (b) the user perspective regarding the device. Discuss ways of enhancing these perspectives. One perspective in regards to the blood glucose device is that many patients find blood glucose testing to be very painful. Ways in reducing the chance of this happening is by pricking and drawing blood from the side of the patient’s finger rather than from the tip or pad of the finger. This will help with easing the pain as there is less concentrations of nerve endings on the finger side compared to the pad or tip of the finger. Additionally a patient can become distressed when a nurse has to prick their finger again, due to the lack of blood flow present to the tip of the patients’ finger because there might not be enough blood in the droplet in order for the blood glucose device to initiate a reading. To enhance this, before pricking the tip of the patients’ finger the user must hold the patients’ hand downwards to enhance blood flow into the finger tip. Many patients also feel anxiety during the whole procedure due to being afraid of what the result might be. Nurses should try to comfort the patient to help them feel at ease. Another patient’s point of view is being afraid of getting an infection from using a common shared glucometer device. Ways of enhancing this perspective include performing hand hygiene in front of the patient before performing blood glucose monitoring, making sure that the blood glucose meter testing strips are sealed before using them, by wearing gloves and opening the test strip in front of the patient to show them that a sealed unused test strip will be used. Moreover, from a nurses’ perspective, to avoid any potential hazardous risks, any used sharps should be disposed of immediately in a sharps container after pricking the patient and not leaving them lying around near any of the patients’ surroundings. Disposal of any sharps is essential and should be done by the user not by one of yo ur colleagues. Wiping the machine with 70 percent isopropyl alcoholwipes after use, properly disposing of the pair of gloves used and proper hand hygiene after every blood glucose test performed should always be done in order to sustain effective infection control. Due to the immediate result from the blood glucose machine, users such as nurses are able to see the test as life-saver in situations where the patient falls hypoglycemic, is unconscious or is hyperglycemic as it provides crucial information that can be used to make rapid decisions as opposed to having to wait for laboratory tests results. References Amoore, J., Paula, I. (3rd August 2002). Learning from adverse incidents involving medical devices. BMJ, 272-275. Barach, P., Small, S. (2000). Reporting and preventing medical mishaps: lessons from non-medical near-miss reporting system. BMJ, 320:759–63. Burden, M. (2001). Diabetes: blood glucose monitoring. Nursing Times, 36-39. Clinical Practice Guidelines. (2006). The management of patients with venous leg ulcers. London: Royal College of Nursing. Colwell, J. A., Dudley, J. D., McDonald, J. M., Metz, R., Raskin, P., Rizza, R. A., . . . Young, D. S. (1987). Self-Monitoring of Blood Glucose. Diabetes Care, 95-99. Hackett, J. (March 1994). Portable Blood Glucose Monitors. Health Devices, Volume 23, No. 3, 64-97. Vickery, S., Beinhaker, K. (2012). Blood Glucose Monitoring (BGM). Performing Quality Control (QC). Interprofessional Clinical Practice Standard- Procedure, 1-4. WorkSafe Services. (March 7 2014). Biological, Physical and Chemical Agents- Definition and Reporting Requirenments. Occupational Health and Safety Act, 9(2)(b), 13, 42, 43(4). What Is an Organizational Structure? What Is an Organizational Structure? Introduction What is an organizational structure? An organizational structure is a formal system to arrange the jobs and coordinates the workers in an organization to achieve a companys goal. In addition, the organizational structure of layers is organized into a hierarchical structure. Moreover, the organizational structure is a good pipeline for channel of communication, arrange tasks, and set the roles, and the relationship of the one department between other departments in an organization. 1.1 A proper organizational structure contributes to effective management. Next, a proper organizational structure needs to have some positive effect. And these positive effects are creating by the advantages of an organizational structure. Advantages of an organizational structure are easy to control and appropriate arrangements the resources to each of the different department, making it easy for employees to know to whom to report by clearly defined reporting lines, minimizing redundancy by excluding extra and unproductive processes, help to reduce the cost because control center is from the micro level to control variety cost and the organizational structure offers main issue and direction to an organization. All types of organizational structure. There are four common structure we can found within organization such as entrepreneurial structures, functional structure, divisional structure and matrix structure. Each structure area there will be having its own management structure. First, entrepreneurial structure is to maintain and manage the large enterprise and an important joint venture. In this structure every play an important roles in relationship to the chief. In addition, this structure has an important pipeline to convey the authority for all levels of management, has a very centralized bureaucratic procedure and everything will be decide by top management. Second, functional structure is a general structure in any organization. This functional structure has divided the activities of the organization into different units or special departmental groups. While each functional structure is controlled by the top level of management. Therefore, this structure is hierarchical structure and centralized structure. Third, divisional structure is basically divided into three different market sectors in an organization. These three different market structures have different tasks. The three different markets are product divisional structure, market divisional structure and geographic division structure. The product divisional structure is a group of the employees involve the production of produce specific commodities then grouped into one division. Besides that, the market divisional structure is based on the market classification of the various operations. For example: business and corporate sale division, and consumer sale division. After that, geographical division structure is a part of an organization. Geographical division structure is a group of the employees located in one geographical location then grouped into one division. For example: European division and south Asian division. The division manager in each country needs to operate the decision making in everyday. Fifth, matrix structure is a system of management and also is a complex structure which includes multiple lines of authority. In the working environment of matrix structure has different professionals together and worker report is more than one person. In addition, in this structure has combined with the basic of functional structure and a basic of project structure. 2.1 What type of business should employ what type of organizational structure? There are many types of business operate in the market so that means the company will employ different types of organizational. There are four common organizational structures such as entrepreneurial structure, functional structure, and matrix structure and divisional structure. Entrepreneurial structure is suitable for small business and in the structure just have entrepreneur and employees. In addition, in this structure only have 1 or 2 people at the top making decision. Moreover, the entrepreneur has authority to control all over aspect of the business and employees by using this structure. Examples of business using this structure are cafà © and tutorial. Functional structure is very general in the organization. In addition, this structure can divides in many different departments. Besides that, this structure is suitable for produce single product and service. Examples of business using this structure are construction and manufacturing. Matrix structure is most complex structure in this four common structure. This structure to have good coordination and information when there is a wide variety of community organizations. Examples of business using this structure are Sunway Group, IOI Group and Berjaya Group. Divisional structure is separate into many departments so easy to work, allocate tasks and controls of their departments. Examples of business using this structure are hospital, shopping center and ice-cream company. 3.1 What is event management? Event management is a process through planned and organized by event managers. It is a broad term and encompasses the allocation, control, direction and analysis of many resources like time, money and products for achieving objective. Managing and planning event is an arduous task. Therefore, business organizations will outsource the task to professional service providers. 3.1.1 The kind of events that the writer manages. The events that the writer manages are make-up show, wedding fashion show and fashion show. These events my MonaLisa Events Management (M) SDN. BHD will help to find the appropriate places for each show, the tools, and the models and so on for satisfy the customers needs and wants and the services. 3.1.2 The background of MonaLisa Events Management (M) SDN.BHD. MonaLisa Events Management (M) SDN. BHD was founded in 2000; MonaLisa offers the most complete facilities and perfect service, we satisfy customers needs and taste and requirement by according to customers. Mona Lisa has come from different professional background of professionals. We use years of experience and mature technology to tailored the customers dream exhibition. Mona Lisa offers the show of make-up, wedding fashion and fashion. We offer the best service to every customer. In addition, hope they that can achieve dreams and successful exhibition. 3.1.3 The organizational structure that the writer want to use for my company. My company is doing about the management of events and manages many types of events. In addition, my company is take the fashion line so our company will needs more different departments to complete the tasks. So, I will use the functional structure for my company structure. Generally the advantages of functional organizational structure are many. But we can see the major advantages there is always occur in functional organizational structure. Firstly, infrastructure can encourage employees to career development. Secondly, because have qualification, talent and knowledge for specialized functions and particular roles are incorporated into sub-categories within company so these benefits had created a clear career paths. Thirdly, employees are arranged on the basis of their common interests so they have opportunity to learn a lot of professional knowledge from each other. Fourthly, skilled employees of the same group can also have the opportunity working with more skilled colleagues who share their professional interests and abilities. Fifthly, the control of functional structure is increased because employees try to supervise each other work. Therefore, the working environment had become productive and enjoyable because of the employees with the spirit of learning. Next, the functional organizational structure also has major disadvantages. Firstly, the organizational of its growing product line is strained because skills and abilities of employees are narrowed and only focus on own area of specialty. Secondly, the problems of communication between departments are always occur different views and opinions because the interaction between various departments are decreased. Thirdly, the flexibility of solving problems, make changes or slow responding to customer demands or needs are create by difficult to analyze which employee is more efficient and which is not. Fourthly, this structure final decision making have to be given from the top level of management because the strategic problems are not given focuses on significant. 3.1.4 The MonaLisa Events Management (M) SDN.BHD organizational structure. For my event management the writer have choose functional structure which need event director, programme coordinator, venue coordinator, equipment coordinator and hospitality coordinator under these department. There are several department as the writer mention above. Conclusion In conclusion, the functional structure is the most general structure in every business. The businesses can use this structure to allocate the tasks be in charge of different departments. In addition, the businesses can learn and understand the ways of how to use functional structure from the major advantages and disadvantages of this type of infrastructure. Moreover, the ways of communication and coordination of each department are very good. Furthermore, the larger organizations will have more challenges so that individuals have the opportunity to realize their potential. The most successful in organizations are small to medium size and merely deal a few product types and services. For countering the weaknesses my recommendations are the company can offers the training programmed periodical. After that, the company also can mobilization the employees to different each departments. Therefore, the employees can enhance their skills and ability. For reduction of conflicting opinions, employees on each department can always held a small discussion. The small discussion is an enable employees proposed and exchange their personal opinions and ideas. Next, employees on the organization can learn how to pay particular attention to services and quality. Then, looking for niches where they can serve customers. Sometimes, employees need to listen to customers about their needs in order to satisfy customers needs. Therefore, using appropriate organization will create good talent of employees and achieve the goal in every time.

The Case Of John Lacking Capacity Social Work Essay

The Case Of John Lacking Capacity Social Work Essay Within adult social care, people, issues, organisations and regulatory bodies are always involved in the discussions on risk and safety. Responsibility, duty of care, adult safeguarding and capacity are of concern. The balance of keeping service users who are viewed as vulnerable safe in society can be contradicted with living independent lives and being able to take the risks others take in everyday life. Therefore, perceptions and assessments of risk is an individual matter for each service user, the communities and society and is fraught with decisions and choices. Mitchell and Glendinning (2007) suggest that the states role and pre-occupation with risk management is under constant evaluation rather than exploring and seeking to understand service users perspectives of risk. They highlight the need for more service users and carers involvement in risks, decision making and protection (Parrott, 2006). Events during the life course such as genetic/biological factors, and childhood experiences can have a huge impact on the ability of the mind and body to develop and maintain good mental health. Ones life course can encounter a combination of stressful events which can test the human bodys ability to cope emotionally, which sometimes can trigger anxiety, depression and/or other mental health conditions. Risk factors which can have a negative impact on ones mental health can be addressed by influencing supportive relationships, a healthy lifestyle, stress management techniques and emotional coping strategies, in which social workers can be apart of ensuring happens. On an individual factor John could be facing depression/grief from the loss of his wife who passed away a year ago. John could still be in the seven emotional stages of grief (Carers UK, 2012). This involves shock or disbelief, denial, bargaining, guilt, anger, depression, and acceptance/hope. Social workers and other prof essionals should be aware that, there are no time limits on grief and no set pattern of emotions and behaviours that people can follow, everyone is different and grief does not always happen straight away. The risk factors for experiencing more serious symptoms of grief/loss of a loved one is that John could be at an increased risk of being psychiatrically unstable due to a decline of his emotional well being. The change in Johns life events/situation could have a huge impact on his mental wellbeing, not only because he has lost his wife but he was also a carer for his wife which would have meant John would have had responsibilities daily. Therefore John also faces having to deal with the loss of his caring role, which he may include him feeling guilty/ relieved, exhausted and alone. John may also feel angry that someone has contacted social services as they feel worried about him, as at this moment in time John may be thinking he is coping fine. Johns family/social factors may be a potential risk as John lives alone and his two children live some distance away and only visit monthly. John could be feeling isolated and due to lack of family support and limited social networks, John could be at risk of deteriorating emotionally and physically. John could be feeling a loss of control over his life due to these changes and he could experience all types of symptoms such as significant loss of appetite, diminished energy levels, suicide thoughts, depression, anxiety and many more (NIMH, 2012). The issues around the perceptions of risk and rights for mental health service users are different as people are sometimes perceived as a risk rather than considered at risk in vulnerable situations. Therefore, John could be at risk of being overlooked by safeguarding practices and his individual rights comprised by the Mental Health 1983 if he is assessed as lacks capacity, when maybe all John needs is some support in getting his life back together and learning how to cope w ith all his life changes. This would be a multidisciplinary decision and user involvement in risk assessment and informed decision making about risks to John and others (Ray, Pugh, Roberts Beech, 2008). Regardless of whether John is assessed as having the capacity or not to make decisions under the Mental Health Capacity Act 2005, then professionals need to raise the awareness of human rights and enable John to have these rights realised. Independence, choice, control and experiences and feelings associated with danger, fear, abuse and safety would need to be addressed with John. Sheldon (2010) suggests that in any case of risk management, the service user should have their rights explained, including their human rights and risk management should not interfere with the service users rights to dignity, respect and privacy as also suggested by the Care Council Code of Practice for Social Workers (CCW, 2002, 1.3, 1.4, 3.1). It is important that the key role of assessments of adults allows people to make their own decisions whilst minimising risk or harm. By placing John at the centre of the caring process, it would be the social workers role to discuss options of support for John as a first option. Fair Access to Care Services would enable the social worker to focus on health, safety, autonomy and involvement with his family and the community but without overlooking risks of self harm, neglect, abuse and risks to carers and others. FACS was launched in 2003 by the Department of Health, so that adults in need can be assessed for eligibility of services (DOH, 2003). It focuses on four levels of risk to independent living, which would be of use in Johns case. Risk taking is a normal part of life, however the social worker needs to ensure they have taken all the steps needed to minimise risk. With John by considering the consequences of actions and the likelihood of harm he could cause to himself, and discussing the benefits for independence and well being, a support plan for managing risk could be put in place with Johns consent (CCW, 2002, 4.3). Risk assessment will help in developing risk management plans that minimize risks (Coulshed Orme, 2006). The social work ers role would be to provide John with support to enable him to help himself. Under the National Health and Community Care Act 1990, the local authority would have a duty to assess Johns needs and to ensure thats services are available for John. Protecting and safeguarding John from harm, abuse and neglect including financial, physical, sexual, emotional and institutionally would be the social workers main role. An assessment based on the needs of John would enable the social worker to build a positive relationship with John, to gather the relevant information, form an overview of the situation and identify possible solutions for the best way forward (Parrott, 2006). Assessment and care planning will enable the local authority to provide practical and emotional support for John. During assessment and care plan the social worker would be able to treat John holistically, promote his independence whilst clarifying risks that can follow from decisions made independently and also being a ble to involve other health professionals to benefit John. Through the care plan, John would be able to access a wide range of information and services, designed specifically for him. Social workers use the Mental Health Act 2005 as a criterion to minimise risk of harm to self or others, however the downside for service users is that of potential threat to independence and freedom that sometimes makes seeking help a hard decision to make in some cases, therefore social workers working in multidisciplary teams and having the use of assessment and care planning tools, makes decision making easier. Therefore all professionals and John would have some responsibility for making decisions and every professional would have input into providing and sharing information to arrive at a considered decision (Milner OByrne, 2009). This also minimises the risk of one person being involved and making decisions solely without having the right knowledge or support to reach appropriate outcomes with John. The autonomy of John to decide whether to engage with social services, and accept that he is not coping well at the moment, conflicts with social services and his neighbours concerns of him putting himself in danger/neglect. The professionals would need good social skills and value the principle of inclusion into society and autonomy to enable John to make his own decisions and make positive changes on his own behalf. The conflict in this case is that facing the social worker in assessing Johns needs. On one hand, John doesnt seem to be coping well however he has been assessed as having capacity, but on the other hand, John is exercising his own right to self determination and autonomy as he wont accept any support. The issue the social worker faces is that of John not engaging if John is able to understand some of the presenting problems in his current situation. In order to assess whether intervention is required, three categories of risk may be required. Johns physical risk could be causing harm to himself or others. Johns social risk of becoming isolated and acting in a way that is considered outside of the social norm and emotional risk, his physical and emotional health (Webb, 2006). In the case of John lacking capacity the social worker and other professionals would be working under the framework The Mental Capacity Act 2005 (MCA) in order to provide protection for John, who is unable to make decisions for himself. The Act contains provision for assessing whether people have the mental capacity to make decisions, procedures for making decisions on behalf of people who lack mental capacity and safeguards. Professionals would be working under the philosophy of the MCA, which is any decision made, or action taken, on behalf of John who lacks the capacity to make the decision or act for himself must be made in his best interest (Coulshed Orme, 2006). The Act is also supported by its own Code of Practice which has to be interpreted when using the Act. It is important that all professionals working with John understand his capacity might be affected only for a temporary period. The phrases used in the MCA section 2 in relation to a matter and at the material time mea ns that capacity must be assessed on a decision-by-decision basis. Therefore, capacity may not be a permanent status and John should not be described as having or lacking capacity. The level of capacity needed by John would depend on the decision to be made. For example, John may need a lower level of mental capacity to make decisions about everyday matters, such as what to eat or where to go at this moment in time. Professional should ensure John has not been assumed as lacking capacity due to his age, appearance, and mental health diagnosis or disability/medical condition (Webb, 2006). In 2007, under the Mental Health Act for England and Wales, Approved Social Workers were replaced by Approved Mental Health Practitioners (AMHPs) with the role and remit extended to other disciplines. The primary role of an AMPH is to act as the guardian of the patients rights. The AMHP has the responsibility of contacting the patients next of kin and to help any appeals against the order that the patient wants to make. In the case of John not having capacity, the AMHP may control access to some services such as day centres, respite care, residential care and other community support services, if needed (DOH, 2001). The social worker would also need to refer to other health/social care professionals if not already done so such as GP, community psychiatric nurse, physiatrist, counsellor, advice services, specific therapies to ensure an holistic approach is taken (Ray et al, 2008). The consultation report on safeguarding adults in Wales In Safe Hands (WAG, 2000) found that people were c oncerned about the balance between safeguarding and personalisation, between choice and risk. Social workers and other professionals need to ensure people have informed choices and introduce support systems. Social workers will have a distinctive role in multiagency settings and will need to ensure they develop practices to enable service users with mental health to identify and realise their own needs. The team involved in working with John will need to have broad experiences and social views of mental health problems especially in regards to discrimination, oppression, civil rights and social justice. They will need to co-ordinate efforts to support John so that he does not have negative experiences and /or perceptions of mental health and ensure he received services fairly and equably. The social worker will work with John to ensure he is not a victim of social isolation, poverty, unemployment, insecure housing and limited social and support networks and will have an independent view in assessment and care planning (Faulkner, 2012). In Johns case risk management will minimize the dangers both to and from John. However risk factors are individual and differ from professional to professional due to personal factors and the degree of control they have over the risk. A risk can be viewed as negative and positive. Risk is associated with decision making processes and should never be made in isolation. Social workers must take every precaution to protect the service user and the public, as the law makes people responsible for behaviours whether or not they were the ones who took the risk, intended or not. Practitioners can be held liable for negligence and a breach of duty. Trying to predict possibilities and risk assessing is a very important part of the social workers role (Parrott, 2006). Part 2

Is Your Body Clear :: essays research papers

 ¡Ã‚ §Is Your Body Clear? ¡Ã‚ ¨   Ã‚  Ã‚  Ã‚  Ã‚   We, as Americans, are immersed in a society of products for sale. With so many items available how do manufacturers entice us to purchase their product over another one? They do this through advertising, or a way of promoting and marketing merchandise. Advertising is a very large industry, and many people spend their entire lives developing advertisements that the average consumer will see, and hopefully will believe. An advertisement is an example of a rhetorical situation. In this rhetorical situation, the advertisers use the concepts of logos, pathos, and ethos to draw the audience in and get their message across to the individual reader. They want the consumers to trust and believe them. Most of all, they want them to buy whatever they have to sell. Companies must rely on advertising a great deal, especially when a new product becomes available. It is crucial that their audience learns of the product and realizes the benefits of the new invention. Companies that already have other products for sale have a better chance of obtaining the consumers interest, especially if the company has a good reputation. One such company is Neutrogena. They have numerous products for sale for the face, hair, and body. One of their newest products is called Body Clear„ § Body Wash. I found this particular ad in a magazine strategically placed toward the front between two different articles. This magazine, YM, is typically intended for young females between the ages of 13 to 19. The target audience for the body wash would therefore have to be intended for these teenage girls. Before we can examine the ethos, pathos, and logos of the ad, we must visualize it. The center of the page has a large picture of the body wash with bubbles dripping over the side and the word NEW printed in black letters across the top of the bottle. Standing next to the bottle of wash in just a towel is the famous Neutrogena girl, Jennifer Love Hewitt. At the top of the page in big, bold, red letters appear the words,  ¡Ã‚ §Clear skin from head to toe. ¡Ã‚ ¨ Underneath this slogan is the caption that introduces the new body wash,  ¡Ã‚ §Neutrogena„ ¥ Body Clear„ § Body Wash treats, even prevents body breakouts. ¡Ã‚ ¨ To the side of the oversized bottle of wash are three bullets, and although very small are still very important. They tell us that the body wash contains an acne fighting ingredient which  ¡Ã‚ §dermatologists recommend.

The Right to Own a Gun Essay -- Argumentative Persuasive Essays

The Right to Own a Gun   Ã‚  Ã‚  Ã‚  Ã‚  Are you willing to sit back and become a victim of violent crime or allow the government to tamper with your civil liberties? In recent years, anti-gun politicians have attempted to control guns in the name of crime prevention this is an assault on the Second Amendment rights of US citizens . The Second Amendment states, â€Å" A well regulated Militia being necessary to the Security of a free state, the right of the people to keep and bear arms, shall not be infringed.† Not only did our Founding Fathers focus their debate on the right of people to keep and bear arms, they devoted energy to encouraging future generations to defend theses freedoms. In defense of gun ownership, Alexander Hamilton said, â€Å"If circumstances should at any time oblige the government to form an army of any magnitude, that army can never be formidable to the liberties of the people while there is a large body of citizens, little if at all inferior to them in discipline and the use of arms, who stand ready to defend their rights and those of their fellow citizens.† During our country’s development hundreds of law-abiding citizens were able to take up arms against lawless mobs to defend themselves, their family, their homes, and their businesses. They did the job law enforcement simply could not do. Lives were saved. Robberies were prevented. Homes and businesses were defended and left intact, all thanks to the Second Amendment to our constitutional, the right to keep and bear arms. Americans have made it clear they reject most government intrusions on their basic civil rights, including the right of gun ownership. According to an April 18, 1994 study by Penn and Schoen Associates, Inc. as many as 85 percent of American adults said they are unwilling to forfeit basic civil liberties even if it could enhance their personal safety. 75 percent agreed that police and the justice systems couldn’t protect them; people said they have to take more responsibility for safeguarding themselves. 62 percent said the need for personal guns ownership is increasing, and a majority is unwilling to accept laws that restrict gun ownership greatly. Guns, Crime, and Freedom states that, no gun law which restricts the right of law-abiding citizens to own guns has been proven to reduce crime or homicides, not even the Brady Law and the â€Å"Clinton Crime Bill.† These two laws st... ...f federal law enforcement agencies did their jobs with respect to guns and convicted violent felons using only GCA’68, as reformed, gun control would not be an issue and we would be a long way toward solving the violent crime problem. We would be getting criminals off the streets and into jail. Americans want violent criminals off the streets and out of their neighborhoods. The bottom line is Americans are upset about crime and soundly reject government solutions that infringe on their rights and liberties.   Ã‚  Ã‚  Ã‚  Ã‚  Ultimately, it is a person’s choice to use firearms to commit violent crimes. So criminals should be controlled, not the guns which they share with millions of law-abiding citizens. Gun control supporters claim that gun control lowers crime rate. We as people need to take a stand and fight for our Second Amendment and the right to bear arms. Gun control advocates need to realize that passing laws that honest gun owners will not obey is a self-defeating strategy. Gun owners are not about to surrender their liberties or their right to bear arms. The Federal Govement of the United States should not be able to take away the right of law-abiding citizens to own a gun.   Ã‚  Ã‚  Ã‚  Ã‚  

The Film, A Respectable Trade :: Slavery Movies

The Film, A Respectable Trade In the film, A Respectable Trade, the account of slavery is different than usually seen. With an English backdrop, the cruelty of the trade was concealed. The slaves were not laboring in fields, but were being trained in house maintenance. On the streets there are no slaves, they are rerouted to the United States where they are traded. Although the slaves in the film are generally absent from the physical atmosphere, they are vital to the economic growth of Bristol, England. Josiah Cole exemplifies the plight of the struggling businessman. His dream of a better life is echoed in today’s capitalist society. His constant drive is to move out of his father’s small home and into a bigger house in a better section of town. He is a shroud businessman who works hard to be innovative and find a new demand for his product. The economy of Bristol seems to revolve around one product, which is traded and sold. This description of Bristol doesn’t seem very different from many of today’s capitalist societies. The one difference is the product that is being sold and traded. The humans that are being treated as cargo change the whole system from a thriving capitalist society to one of slavery. The town of Bristol becomes the economic center for slave trading. The slaves are seldom seen, but th e money gained from their trading is essential to the town. Cole is taking a business risk by bringing the slaves to Bristol; most of the slaves are traded for other goods by the time they reach the port. He is refining the product he trades in hope that it will fetch him a higher price. The more refined the slave is, the higher price he can charge. This simple business venture is made complicated by social standards because he is trading human beings. Watching this class process of slavery now, from a different societal standpoint, seems foreign. But to the slave traders, such a Josiah Cole, they ignored the fact that they were buying and selling human beings and avowed that they were involved in, A Respectable Trade. A Respectable Trade, portrays slaves in a unique light. Most scenes of slavery in film show slaves working in the fields of southern states in the 19th century.

I deserve to win Essay

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Comparative advantages and disadvantages of cone crusher

chamfer Crusher is astray used range, high efficiency crusher, bevel crusher according to the scope of use, downcast into gross, modal(a) and fine suppression three pieces on the current situation of China crushed ore concentrator plant of view, broken equipment powered by the standard grammatical case strobile crusher, crushing equipment uses a short head type cone crusher, has more or less finalized. However, Instead of employ crushing equipment cone crusher, Jaw crusher Is to use.For victorian selection and perspicacious use of coarse crushing did not prep ar, now they are briefly analyzed and compared as al lowlys. strobile Crusher (compared with the Jaw crusher) mall advantages 1, crushing chamber depth, continuous operation, high employment capa urban center, low power exercise unit. Compared with the same largeness to the mine mouth Jaw crusher, the production capacity is higher than the latter much than doubled, while electricity purpose per ton of ore is 0. -1. 2 measure lower than the palaver 2, work is comparatively stable, vibration lighter, littler basis tilt of the railcar equipment. Cone crusher weight basis, usually 2-3 quantify the weight of machinery and equipment, and Asia weight jaw crusher machine was 5-10 times its own weight orchestra pit equipment http//www. Quarry-equipment. Com/ stone plant httpwww. Quarry-equipment. Com/products/j-jaw-crusher. HTML In make energy, transportation energy saving promising.Greenhouse gases living 50 billion square meters of urban and rural construction, expression energy emissions accounted for deuce-ace of the greenhouse gas emissions, while the city has air- conditioning system energy consumption accounted for 50% of total energy consumption of the building. If you can start the zero emissions building projects in mom more positive cities in the country, this market will be very large.Currently, crossing vehicles, electric vehicles, give the sack cell vehicles and other research and evolution work in continuing to kick upstairs our country may be the counterbalance breakthrough in hurt of hybrid cars. Although we still lags behind in terms of battery, charging system, energy conversion metering control system, alone it also gave birth to a great opportunity. Stone crusher http//www. Stonecutter. Org/ stone crushers http//WV. Stonecutter. Org/Grammaticalness/Jaw-Crusher. HTML proportional advantages and disadvantages f cone crusher and jaw crusher By wayfaring type cone crusher, has almost finalized.However, instead of using crushing equipment cone crusher, Jaw crusher is to use. For proper selection and rational use follows. Cone Crusher (compared with the Jaw crusher) principal(prenominal) advantages 1, consumption per ton of ore is 0. 5-1. 2 times lower than the Jaw 2, work is relatively basic weight Jaw crusher machine was 5-10 times its own weight quarry equipment quarry plant http//www. Quarry-equipment. Com/products/c-awe-crusher. HT ML In stone crushers http//www. Stonecutter. Org/Gerrymandering/Jaw-Crusher. HTML