Patient Safety Incident (PSI) Essay -- Resident Care

Living in a care home often results in residents becoming less independent with respect to their ability to exercise their rights and responsibilities. Some care home routines restrain residents. For instance, care homes sometimes use cot-sides or cocoon beds, which are designed to reduce falls but are often ineffectual with demented residents, who tend to climb over the rails and fall from a great height. In addition, residents often develop problems such as pressure sores, incontinence, muscle wastage and worsened mental conditions due to the use of such beds. This paper describes the Patient Safety Incident (PSI) designed for Hollybrook (HB) care home, at which I work as a professional care worker. The first part of the paper explores the information systems in use at HB and it argues that Patient Safety Incident (PSI) is a result of adverse events that tend to be more organisational than clinical in their aetiology. From an organisational perspective, PSI records help one to understand the causes of errors relating to communication, teamwork and care process design, in a way that is different to that of clinical epidemiology. This part of the paper outlines the information required to sort and organise records in order to make it easier for staff to use them. These records list the contact details of residents, their Medical Administration Record (MAR) and accident/incident records. Designing the record around the database makes it easier for staff to sort out and identify, for example, all residents who are taking controlled medicat ions or whose risk assessment needs closer observation by internal staff. A database application will also help HB to reduce the overall burden of the traditional paper method and will e... ...nce an incident that may not be seen as such by staff working in the same environment but, if the staffs have frequently witness that the same incident occur; they may stop reporting the incident. However, database application system can save charting time which could be utilized to provide care to residents. Administration function like medical records, risk assessments, daily reports and coding requires documentations from the service users` electronic medical record database to enhance the EHR, which link the EHR data with databases containing standardized assessment information from external healthcare systems. If the database is not similar as to what other healthcare systems use, it is impossible to share information from EHR database with other clinical application systems. Works Cited 1. EBRAHIM,A (2011) NAMIBIAN EDUCATION CENTRE, NAMIBIA Patient Safety Incident (PSI) Essay -- Resident Care Living in a care home often results in residents becoming less independent with respect to their ability to exercise their rights and responsibilities. Some care home routines restrain residents. For instance, care homes sometimes use cot-sides or cocoon beds, which are designed to reduce falls but are often ineffectual with demented residents, who tend to climb over the rails and fall from a great height. In addition, residents often develop problems such as pressure sores, incontinence, muscle wastage and worsened mental conditions due to the use of such beds. This paper describes the Patient Safety Incident (PSI) designed for Hollybrook (HB) care home, at which I work as a professional care worker. The first part of the paper explores the information systems in use at HB and it argues that Patient Safety Incident (PSI) is a result of adverse events that tend to be more organisational than clinical in their aetiology. From an organisational perspective, PSI records help one to understand the causes of errors relating to communication, teamwork and care process design, in a way that is different to that of clinical epidemiology. This part of the paper outlines the information required to sort and organise records in order to make it easier for staff to use them. These records list the contact details of residents, their Medical Administration Record (MAR) and accident/incident records. Designing the record around the database makes it easier for staff to sort out and identify, for example, all residents who are taking controlled medicat ions or whose risk assessment needs closer observation by internal staff. A database application will also help HB to reduce the overall burden of the traditional paper method and will e... ...nce an incident that may not be seen as such by staff working in the same environment but, if the staffs have frequently witness that the same incident occur; they may stop reporting the incident. However, database application system can save charting time which could be utilized to provide care to residents. Administration function like medical records, risk assessments, daily reports and coding requires documentations from the service users` electronic medical record database to enhance the EHR, which link the EHR data with databases containing standardized assessment information from external healthcare systems. If the database is not similar as to what other healthcare systems use, it is impossible to share information from EHR database with other clinical application systems. Works Cited 1. EBRAHIM,A (2011) NAMIBIAN EDUCATION CENTRE, NAMIBIA

Charles Bukowski’s Diction

Diction refers to the writer's distinctive vocabulary choices and style of expression in a poem or story. A secondary, common meaning is more precisely expressed with the word enunciation – the art of speaking clearly so that each word is clearly heard and understood to its fullest complexity and extremity. Diction has multiple concerns; register words being either formal or informal in social contexts. Literary diction analysis reveals how a passage establishes tone and characterization. Knowing this, how can we apply this conception to Bukowski's works? It's simple: What is most important about Bukowski's works is the accessibility.His works are written in plain language which makes them a fast read, and â€Å"easily† translatable (although the bests are always the originals). Charles Bukowski's style is reportedly one of the most imitated in the world due to its simplicity, and has influenced numerous writers in the realism movement, which doesn't mean that this styl e is an easy choice, mostly because his writing was, among other peculiarities, heavily influenced by the geography and atmosphere of his home city (Los Angeles) and is marked by an emphasis on the ordinary lives of poor Americans, the act of writing, alcohol, relationships with women, and the drudgery of work.His voice is from people who occupies a place among those outcasts, outlaws, madmen and solitaries whose outspoken visions achieved against all odds a global presence. Henry Miller, Samuel Beckett, Jack Kerouac, Allen Ginsberg, Hubert Selby Jr. and William Burroughs were some authors who, as Bukowski, made use of these themes to expess their own points of view in a very particular way, being Bukowski the most â€Å"objective and clear† and non-scholarly one of them.Yet, even among such outsiders, he remains outside, a consummate loner, since the others, unlike him, reveal in their various styles a certain hard-won haggling with literature that was, to him, the stuff of dupes. The tone of most of Bukowski's works is autobiographic and often reffers to his feelings of a permanently disfigured boy in early adolescence by painful boils, so severe that they had to be surgically lanced.He also worked in a succession of heartbreaking menial jobs, culminating in a numbing nine-year stint in the U. S. Post Office, facts that would give him a lot to write about, especially his feelings in relation to these facts. He perfectly depicted the depravity of urban life and the downtrodden in American society. Bukowski relied on experience, emotion, and imagination in his work, using direct language, violence and sexual imagery.He writes with a nothing-to-lose truthfulness which sets him apart from most other autobiographical novelists and poets. He has established himself as a writer with a consistent and insistent style based on what he projects as his ‘personality,’ the result of hard, intense living and the sense of a desolate, abandoned world. In addition to desolation, Bukowski’s free verse tackles the absurdities of life, especially in relation to death.The subject matters of this world are also drinking, sex, gambling, and music; the Bukowski style, however, is like a crisp, hard voice; an excellent ear and eye for measuring out the lengths of lines; and an avoidance of metaphor where a lively anecdote will do the same dramatic work. Furthermore, his grace with words gives a comic gleam to even his meanest revelations. Bukowski’s poems give the impression that they're best appreciated not as individual verbal artifacts but as ongoing installments in the tale of his true adventures, like a comic book or a movie serial.They are strongly narrative, drawing from an endless supply of anecdotes that typically involve, for ex: a bar, a skid-row hotel, a horse race, a girlfriend, or any permutation thereof. Bukowski’s free verse is really a series of declarative sentences broken up into a long column, the sho rt lines giving an impression of speed and terseness even when the language is sentimental or cliche. Maybe that is the reason of way the readers feel so close to him, as we're talking to a close friend.The fact is that, with his own simple diction, which is so direct and easy understandable (but yet deep, sensitive and real at the same time) we can really feel ourselves in what he's talking about, even if we have no idea of what it is like to be in his shoes. In the end, we relate his experiences as the world and people as they really are, and we can't hide from it any longer. it's true: pain and suffering helps to create what we call art. given the choice I'd never choose this damned pain and suffering for myself but somehow it finds me as the royalties continue to roll on in.

500 Million Years of Fish Evolution

Compared to dinosaurs, mammoths and saber-toothed cats, fish evolution may not seem all that interesting — until you realize that if it werent for prehistoric fish, dinosaurs, mammoths, and saber-toothed cats would never have existed. The first vertebrates on the planet, fish provided the basic body plan subsequently elaborated on by hundreds of millions of years of evolution: in other words, your great-great-great (multiply by a billion) grandmother was a small, meek fish of the Devonian period. (Here are a gallery of prehistoric fish pictures and profiles and a list of ten recently extinct fish.) The Earliest Vertebrates: Pikaia and Pals Although most paleontologists wouldnt recognize them as true fish, the first fish-like creatures to leave an impression on the fossil record appeared during the middle Cambrian period, about 530 million years ago. The most famous of these, Pikaia, looked more like a worm than a fish, but it had four features crucial to later fish (and vertebrate) evolution: a head distinct from its tail, bilateral symmetry (the left side of its body looked like the right side), V-shaped muscles, and most importantly, a nerve cord running down the length of its body. Because this cord wasnt protected by a tube of bone or cartilage, Pikaia was technically a chordate rather than a vertebrate, but it still lay at the root of the vertebrate family tree. Two other Cambrian proto-fish were a bit more robust than Pikaia. Haikouichthys is considered by some experts--at least those not overly concerned by its lack of a calcified backbone — to be the earliest jawless fish, and this inch-long creature had rudimentary fins running along the top and bottom of its body. The similar Myllokunmingia was slightly less elongated than either Pikaia or Haikouichthys, and it also had pouched gills and (possibly) a skull made of cartilage. (Other fish-like creatures may have predated these three genera by tens of millions of years; unfortunately, they havent left any fossil remains.) The Evolution of Jawless Fish During the Ordovician and Silurian periods — from 490 to 410 million years ago — the worlds oceans, lakes, and rivers were dominated by jawless fish, so named because they lacked lower jaws (and thus the ability to consume large prey). You can recognize most of these prehistoric fish by the -aspis (the Greek word for shield) in the second part of their names, which hints at the second main characteristic of these early vertebrates: their heads were covered by tough plates of bony armor. The most notable jawless fish of the Ordovician period were Astraspis and Arandaspis, six-inch-long, big-headed, finless fish that resembled giant tadpoles. Both of these species made their living by bottom-feeding in shallow waters, wriggling slowly above the surface and sucking up tiny animals and the waste of other marine creatures. Their Silurian descendants shared the same body plan, with the important addition of forked tail fins, which gave them more maneuverability. If the -aspis fish were the most advanced vertebrates of their time, why were their heads covered in bulky, un-hydrodynamic armor? The answer is that hundreds of millions of years ago, vertebrates were far from the dominant life forms in the earths oceans, and these early fish needed a means of defense against giant sea scorpions and other large arthropods. The Big Split: Lobe-Finned Fish, Ray-Finned Fish, and Placoderms By the start of the Devonian period--about 420 million years ago--the evolution of prehistoric fish veered off in two (or three, depending on how you count them) directions. One development, which wound up going nowhere, was the appearance of the jawed fishes known as placoderms (plated skin), the earliest identified example of which is Entelognathus. These were essentially larger, more varied -aspis fish with true jaws and the most famous genus by far was the 30-foot-long Dunkleosteus, one of the biggest fish that ever lived. Perhaps because they were so slow and awkward, placoderms vanished by the end of the Devonian period, outclassed by two other newly evolved families of jawed fish: the chondrichthyans (fish with cartilaginous skeletons) and osteichthyans (fish with bony skeletons). The chondrichthyans included prehistoric sharks, which went on to tear their own bloody path through evolutionary history. The osteichthyans, meanwhile, split into two further groups: the actinopterygians (ray-finned fish) and sarcopterygians (lobe-finned fish). Ray-finned fish, lobe-finned fish, who cares? Well, you do: the lobe-finned fishes of the Devonian period, such as Panderichthys and Eusthenopteron, had a characteristic fin structure that enabled them to evolve into the first tetrapods — the proverbial fish out of water ancestral to all land-living vertebrates, including humans. The ray-finned fish stayed in the water, but went on to become the most successful vertebrates of all: today, there are tens of thousands of species of ray-finned fish, making them the most diverse and numerous vertebrates on the planet (among the earliest ray-finned fish were Saurichthys and Cheirolepis). The Giant Fish of the Mesozoic Era No history of fish would be complete without mentioning the giant dino-fish of the Triassic, Jurassic and Cretaceous periods (though these fish werent as numerous as their oversized dinosaur cousins). The most famous of these giants were the Jurassic Leedsichthys, which some reconstructions put at a whopping 70 feet long, and the Cretaceous Xiphactinus, which was only about 20 feet long but at least had a more robust diet (other fish, compared to Leedsichthys diet of plankton and krill). A new addition is Bonnerichthys, yet another large, Cretaceous fish with a tiny, protozoan diet. Bear in mind, though, that for every dino-fish like Leedsichthys there are a dozen smaller prehistoric fish of equal interest to paleontologists. The list is nearly endless, but examples include Dipterus (an ancient lungfish), Enchodus (also known as the saber-toothed herring), the prehistoric rabbitfish Ischyodus, and the small but prolific Knightia, which has yielded so many fossils that you can buy your own for less than a hundred bucks.