Clinical decision making (not to take blood cultures from a febrile Essay

Clinical decision making (not to take blood cultures from a febrile patient) - Essay Example To diagnose the cause, blood culture is mostly required for identification of causative bacteria or fungus. A nurse caring for a patient with acute leukaemia is many a time confronted with the clinical scenarios where he or she is required to make clinical decision to take blood culture from a febrile patient. The nurse may herself make the decision to obtain a blood sample for culture on suspicion of an infection or may act on the orders of a physician. In an autonomous decision, the complexity and the nature of the decision task affect the approach taken towards problem solving (Thompson, Kirkness & Mitchell 2007). The decision taken by the nurse can be analysed for the application of evidence based medicine in routine clinical situations. Decision analysis allows to share a decision with seniors and colleagues and to evaluate its advantages and disadvantages (Bucknall 2003). Nurse uses the domains of prior knowledge about the patient and his circumstances, ethical knowledge and specific knowledge. This knowledge is accessed and applied by the means of pattern recognition and heuristics (Bohinc & Gradisar 2003). First of all, the component of problem recognition requires the nurse to identify the ‘cues’ or clinical symptoms such as fever in this case. The recall of these cues leads to formulation of a hypothesis of a problem (Jenks 1993). Once the problem has been recognised, the decision maker proceeds on to the next step of assessment in which the data is gathered, assimilated and analysed (Klein 2005). The nurse records the temperature, maintains a temperature chart and records associated symptoms such as chills, sweating, cough and pattern of fever etc. as a part of data collection. To be able to form a judgement, it is imperative to evaluate and make a choice (Higgs et al 2008; Connolly, Arkes & Hammond 2000). The nurse evaluates the data and infers about what should be done (Thompson &

Descriptive statistics Essay Example | Topics and Well Written Essays - 750 words

Descriptive statistics - Essay Example Differences in the mean pretest and posttest scores were computed to find out the extent in the change of confidence level brought about by the CRRP course. A higher mean difference value would indicate a higher degree of change in confidence level brought about by the CRRP course. Range and standard deviation measured the variability of the computed values in the study (Agresti & Finlay, 2009). A nurse leader may use descriptive statistics in cases when the â€Å"average† result is helpful in determining a course of action. In such cases, descriptive statistics are persuasive enough because it is able to give an overall picture of the data set in discussion. However, descriptive statistics, as the name implies simply provides a description of the data set and does not allow the nurse leader, to make inferences regarding the data (Malone, 2001). Based on my personal experience, we use descriptive statistics (particularly mean values) to find the prevalent cases in the nursing unit. Our department also routinely conducts a nurses’ evaluation assessment and our mean performance scores are usually given to us. Usefulness of Confidence Intervals in Determining Clinical Significance Confidence intervals indicate how variable the study data are, that is, the average distance of the data set values from the mean (Lee & Zelen, 2000). It should be noted that the true condition of a given population would be almost impossible to determine. Thus, researchers rely on the condition of a sample to provide a picture of the population. Confidence intervals aid researchers, analysts and practitioners in making decisions with regards to the clinical relevance of the data at hand. For example, if a study indicates a confidence interval of 95%, then the reader is able to determine that the values or the assessment given in the study is true for the population 95% of the time. The shorter the confidence interval, the more accurate is the assessment (Maki, 2006). For e xample, suppose a trial was conducted on the effectiveness of a weight loss pill against a placebo. Results of the study indicate that at a 95% confidence level, the weight loss was given to be 9 lbs. This means that the weight loss range would be between 4 to 14 lbs. Another interpretation of this information would be that it is highly likely for the pill to reduce one’s weight by at least 4 lbs, but highly unlikely for it to reduce one’s weight by more than 12 lbs. In this case, although the 9 lb weight loss arrived at was essentially just an estimate, the confidence interval that was set for the trial was able to quantify the uncertainty that was associated with that estimate (Malone, 2001). Clinical Significance vs. Statistical Significance Statistical significance measures the likelihood that the differences in the results of a particular test is due to the intervention applied on the treatment group and not simply due to chance (Malone, 2001). The most common mea sures of statistical significance, or hypothesis testing, are confidence intervals and p-values. On the other hand, clinical significance measures the magnitude of the differences created by the intervention on the daily lives of the participants (Agresti & Finlay, 2009). One controversy surrounding the issue between clinical and statistical significance is that statistical significance does not provide a clear picture of how large is the

Zara Company Analysis

Zara Company Analysis I selected Zara to be the topic of my strategic management individual assignment. Ive chosen this topic because Zara is one of the leading companies in the fashion industry and they follow strategies that give them competitive advantage over other competitors like: MANGO, NEXT, GAP, HM. In this paper Im going to discuss the companys background and history, the SWOT analysis, the strategies that adopted in the company, challenges, opportunities, and the mission vision and objective. Background of the company Zara is a clothing retailer who has taken a new approach in the industry. It was founded by Amancio Ortega in 1963 in Spain. Its parent company is owned 60% INDITEX by the Ortega family and Inditex has carried out in 2005 to 6.741 billion turnovers. Zara has about 2000 thousands branches around the world. Zara is a distributor of apparels. It offers a wide range of choices: the collections for women, men and children. However, the brand launched a line of cosmetics, perfumes and household products. Since the beginning of its establishment, the main idea of à ¢Ã¢â€š ¬Ã¢â‚¬ ¹Ãƒ ¢Ã¢â€š ¬Ã¢â‚¬ ¹Zara is to make luxury products accessible to everyone. Thus, they managed somehow to democratize luxury manufacturer of products inspired by the evolution of fashion. With this policy, Zara is now an industry capable of offering trendy products at affordable prices. On the other hand, it is a company that wants to be close to young people. Also, this desire is felt in its recruitment policy. Zara young employees with styles very marked fashion. However, Zara understands what exactly the customers need and respond to their needs very quickly. Thats the main secret of Zara, which gives them a competitive advantage. Vision, mission, and objectives VISION To be number one fashion retailer. MISSION The world is getting smaller; we want the whole world to dress in style, class, and experience unique designs weekly. Objectives The main objective is to increase the customers demand and satisfaction, by giving them the chance to experience new unique designs weekly. Spread widely and open more branches in the main cities around the world and cover 80% of them by the end of 2011. SWOT Analysis Zaras strategy has both opportunities and strengths of threats and weaknesses. The following section will describe the four dimensions of Zaras agile approach. (S)trengths: Zaras value chain is vertically integrated, which offers many advantages. It can react quickly and it may have high control over the entire process from design to final product. Supply chain is efficient when they have a smooth use of distributions centers and warehouses. Its strategy also allows distributing the products within a wide geographic range within a very short time. The other thing also is that the products are close to market demand. Their products are made only in limited editions; consequently, they must sale their products in short period of time so they can be sold at full price without having them to be returned. This responsive approach involves both lower marketing costs, and higher profit margins for the company. IT integration is also an important aspect of Zaras strategy which is significant as it enables information sharing between different joints within the company. (W)eaknesses: Zaras business model is certainly well adapted to todays needs. But it has a significant weakness, which is that it is difficult to exploit the scalability of a continued expansion. Zara accounts for 80% of consolidated sales Inditexs, which means that the entire group is very dependent on Zaras sales figures. The vertical integration of supply chain has its limitations in scalability. Zara cannot produce clothing in larger quantities for a lower cost, and then the whole concept is based on insignificant quantities as quickly distribute to the stores. The rapid processes can thus compromising the quality in some cases. To always be close to market and capture the latest trends and translate them into clothes that are ready for sale within a short time requires outstanding effort from the employees and the management. Zara fails to implement online shopping which leads to lose orders to their competitors. (O)pportunities: Online shopping became huge and significant market; customers can go online and order what they need. If Zara allows customers to purchase online, that would increase their sales. Pablo Isla is the first Deputy Chairman and Chief Executive says: we view our entry into the Indian market to be of significant strategic importance. (T)hreats: The first threat is that the rent is continuously increasing in malls, Zara need to afford the high cost of rent, which means that they have to increase prices or cut other costs. The main competitors of Zara are HM, GAP, NeXT, and Uniqlo. These companies compete with Zara in several categories like: valuation. , sales, financial ratios, and profitability. Moreover, there is competition with the Asian clothing industry, which starts brands can earn price premium over the competitors in this industry. Challenges facing the company The Textile The textile industry is undergoing dramatic changes. This is an area that requires unskilled labor, which many relocation of production abroad (mostly in Asia) in order to lower costs. In addition, there is a certain paradox. Lower costs can certainly develop a competitive advantage, but if all companies do so, they may not have a competitive advantage. Thus, innovation plays a key role in building the advantage against competitors. The question now is how to gain time in order to be more responsive to customer requests. Zara has understood this need and its strategy, is essentially based on the time savings. The two risks in the textile: Demand Three adjectives can describe the demand part. First, it is unpredictable, which means studying the market may give an indication of demand characteristics. Second, it is a variable; it follows the fashion trends. Demand is also volatile, remain loyal to a brand is not the objective of the consumer. The two important things to the customer are the aesthetics and the price: no matter who proposes, as long as it pleases the customers and the prices are reasonable, then they will buy. Competition The textile sector is hyper competitive. The competition is twofold: that of basic products from countries with low production costs, and global companies that offer products high-end. Moreover, competition depends on costs but also on quality, image, responsiveness and, logistics company. Today, off shoring does not only to create a competitive advantage. Other factors should be taken into account. New markets The sales area is centered in Europe. The desire to penetrate a new market is ready for any enterprise. However, in the case of Zara, this conquest is hampered by the centralization of management and production. It appears as the first drawback of the strategy of the company. Therefore, they should revise the strategy to integrate the North American market, one of the largest markets in the world. Thus, they planned to open a distribution center in Mexico to serve the U.S. market. Competition with China This country is the largest producer and exporter of textiles. The lifting of EU quotas (in place since 1974 with the Multi-Fiber Agreement) the 1janvier 2005 has completely destabilized the textile sector (liberalization of world trade). The entry of China into the WTO in 2002 had already had a dramatic impact on the textile sector. According to the European Apparel and Textile Organization (EURATEX) in 2004, 165,000 jobs have been lost and it is anticipated the loss of a million jobs. A major advantage of China is its low production costs (for the violation of workers rights). More generally, Asia alone accounts for 75% of global textile production. China produced in 2003 17% of global textile and with the abolition of quotas, its share reached 50% within three years. Strategy of Zara All functions are centralized at Zara in La Coruà ±a (design, marketing, and communication), enabling cost control and responsiveness. The competitive advantage of the company based on three factors: quality items, reasonable prices and very short response time. Creating and marketing The degree of development of Zara is quite low, they copy the haute couture models: 40 researchers to attend fashion shows around the world and retain the ideas of top designers to fit the model Zara. About 11000 models are available per year, while other competitors have around 3,000 models. The Spanish firm has 12 collections a year, which is huge in this sector. Communication is minimal because Zara is about 0.35% of its turnover, in contrast to other textile companies who spend 3-4% on average. This reflects the lack of advertising campaigns and the consolidation of the communications department at Corunna. The groups websites are in English or Spanish, you cannot buy over the internet which reduces the cost of site management. Their philosophy is: No Marketing, no communication. Time Time is more important than costs. It is a primary fact in the world of fashion. Design, manufacture and delivery can be done within fortnight, while the market average is about two months. It is interesting to quote the remark of one analyst: Manufacturing activity is Inditex a cost center that has for vocation to better serve the sales activities. The cost is certainly higher than 20% of outsourcing but it is more than offset by increased reaction rate and a lower risk. The time strategy is the dominant strategy, because as I mentioned above, time is a cost itself for the company, so when Zara manufacture and deliver the products in two weeks while the others take months to finish this process, this means that Zara will have the chance to reduce costs and increase revenues, also increase the intangible and tangible assets of the company. Competition Zara cannot afford to operate in an extremely competitive market. So it must offer products of superior range by responding quickly to customer requirements and desires. Therefore, the distribution is important because it represents up to half the cost of the product, which means that the competitive advantage is created by low distribution costs. Marketing and sales Signs are open in the inner cities in order to compete with more expensive brands, being present in the very neighborhoods merchants in large cities. Stores are proper name, there are no deductibles Zara. The level of inventory turnover is very high; the shops are stocked twice a week, which creates a certain image of scarcity that can attract customers who do not hesitate to come to Zara quite frequently in order to discover the new collections of articles. Conclusion After we saw this issue appears, the disadvantages and advantages of Zaras strategy. First, it is important to note the unusual degree of it, since it is totally different from that established by the other competitors. The strategy worked to some extent but in the long run, it seems impossible to continue because as we saw in Part III, it is a barrier to entering new markets. In a context of globalization, it seems completely incongruous. If Zara wants a foothold in the U.S., it must decentralize its production, or need to relocate its production factors. The time factor can nevertheless still be the key to the European market but to enter the U.S. market, another strategy is to be considered. But, will they be sufficient to counter the Chinese giant?

Case Study Bayfield Mud Company Essay

1. What is your analysis of the bag weight problem? The problem begin when Wet-Land Drilling, Inc. had filed a complaint that the bags it received from Bayfield were short-weight, according to previous send the weight of the bags used to be 50 pounds, however the new arrivals show a weight of 47.5 pounds per bag, causing a conflict to the company. The company present the problem as a increased of demand, hiring new employees with a lack of training, new employees occupy the night shift, where old employees check the production, however the double checking of the bag still a problem to the company. First of all we need to analyze and find the errors the process could have, caused by the increased of demand and a lack of control due the old employees, for the analysis I will use the Statistical Process Control (SPC).  ¨Statistical process control (SPC) involves using statistical techniques to measure and analyze the variation in processes. Most often used for manufacturing processes, the intent of SPC is to monitor product quality and maintain processes to fixed targets. Statistical quality control refers to using statistical techniques for measuring and improving the quality of processes and includes SPC in addition to other techniques, such as sampling plans, experimental design, variation reduction, process capability analysis, and process improvement plans. ¨(reliability.sandia.gov, Statistical Process Control) We have and average of 50 pound from older shipment, this is the correct weight that the bags should have so, X=50, also we have a standard deviation of 1.2 which is also the desired level, so o=1.2, for the determination of the bags we need to resolve this formula [pic] 0.489 and a 99.73% confidence interval Z = 3: UCL= x+ 3ÏÆ'x=50+3 x 0.4899=51.4697 LCL= x – 3ÏÆ'x=50-3 x 0.4899=48.5303 The Percentage of Bags with Average Weight within Control Limits (Per Shift) Day Shift = 23 bags/24 bags = 96% Afternoon/Evening Shift = 12 bags/24 bags = 50% Night Shift = 12 bags/ 24 bags = 50% 2. What procedures would you recommend to maintain proper quality control? I recommend making a constant control, trying to make the double checked of the bag weight, also is important for the company to create a mean and range charts guide, that will help the employees to make the control of the bags, this also will help bag packers to make and extra control to the bags, avoiding any errors in weight. Is important to buy scales in the production area and in the bag packers area, the scale will be accompanied by the mean and wage charts, reducing the errors of weight. Also use camera in the areas and training process fro new employees about the doze and the mean and wage of every bag. Reference reliability.sandia.gov, Statistical Process Control, retrieved 12 August 2010, from http://reliability.sandia.gov/Manuf_Statistics/Statistical_Process_Control/statistical_process_control.html

The Death Of The Hall - 952 Words

He stood. Drawing back his shoulders, he spun to face the throng. Considering the number of people present, it was eerily quiet in the Hall, so silent Audra heard the rush of blood in her ears. Edgy but determined to make her people understand they would not dictate her love life, she took Maxen by the hand and led him toward the dais. She took the small step up and stood before her throne, yet he still stood taller than her. Audra kept her fingers laced with his, prepared to make her case, when cheers, clapping, and foot-stomping ensued. Most of the women were tearful—Audra hoped with joy—and the knights appeared jubilant, especially the older ones who had known Maxen from years ago. Her eyes swept the back of the crowd. Corsen smiled and clapped, as did Dillan, but Rory, his face still obscured by his hood, backed out of the Hall. After the endless cheering, people began to ask questions. â€Å"When is the wedding?† â€Å"Where will it be held?† â€Å"May we all attend?† â€Å"I’d like to offer my services†¦Ã¢â‚¬  â€Å"I can bake for you!† Chuckling at the enthusiasm and sniffing back her threatening tears, Audra held up a hand, encouraging quiet. â€Å"The fact you accept this and seem happy for me is all I could want. However, Maxen and I have decided to wed in a private ceremony next month.† What sounded like a single grown of utter disappointment rose from the attendees. Audra chuckled. â€Å"Your enthusiasm touches us. Although Maxen and I will wed privately, we shall have a feast for all when weShow MoreRelatedThe Death Of Harold Hall714 Words   |  3 Pagesgoes, Politics will be the death of you. But could this actually be a dark secret of Governor Hall’s death? The death of Harold Hall has sent many into a state of shock. However, this loyal leader did not start off as a governor. 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This speech has been played for countless people over these years to motivate companies, teamsRead MoreThe Pro Football Hall Of Fame And The Year Of His Death1252 Words   |  6 PagesAbstract The subjectively informative written speech was given in 1970 right before his induction into the Pro Football Hall of Fame and the year of his death. This speech applies to multiple areas professional, sports and personal, because of the principles of winning and success throughout it. Mr. Lombardi could never have imagined the impact that this speech would have on the world over 25 years later. This speech has been played for countless people over these years to motivate companies,Read MoreThe Man In The Dead Machine Summary1358 Words   |  6 PagesIn the poem â€Å"The Man in the Dead Machine,† Donald Hall uses vivid imagery and alternative scenarios to emphasize the sheer overwhelming specter of death that loomed over those serving in the greatest conflict known to man. 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Professionalism Of The Business Industry - 2175 Words

The purpose of this research is to educate or inform people, who are working or about to work in the field of business, about professionalism in the business industry because it is extremely complex and important. Besides from wearing proper attire or having higher education, many set standard of procedures must be abided by to be recognized as professional (Beaton, 2010; Granowski, 2012). As Granowski and Beaton suggests or implies, professionalism is not easy to acquire because it exists for the purpose of satisfying the customers, who are individuals with various and unique personalities. The goal of business is to make profit. As long as customers desire and expect professional service, business must be able to provide that. Professionalism validates quality of business, and thus results in desired future business endeavors. In this regard, Beaton (2010) provides an appropriate example which illustrates doctors. He states that doctors are expected to be safe and bring positive outcome by their patients because they hold and exhibit their degree, wear proper uniform, maintain overall hygiene, and use educated and sophisticated words that lead patients to completely believe that doctors will even sacrifice themselves to help patients. No one wants to be frauded, and professionalism is like antibiotic that kills that worry of possibly being frauded. Beaton’s example undoubtedly depicts that professionalism ensures that business is trustworthy, and ultimately, willShow MoreRelatedNorth Metro Home Services ( Nmhs ) Is Owned By Cody And Tera Hopkins1720 Words   |  7 PagesNorth Metro Home Services (NMHS) is owned by Cody and Tera Hopkins, Cody Hopkins has over 20 years of experience in the plumbi ng industry as a master plumber. The company is a small privately-owned plumbing company headquartered in Stanchfield, MN operating from the residence of Cody and Tera Hopkins. 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Although, these skills were the basis of business management and hospitality industry, they have been increasingly required in health care industry and have become and important aspect for job seekers in healthcare. Importance of Professionalism, Communication and Collaboration in Workplace Professionalism often gets interpreted as the knowledge of one’s profession or vocation, but over the years, it has developed into much

Comparing the Impact of Colonization in A Small Place, A...

Impact of British Colonization Exposed in A Small Place, A Passage to India, and Robinson Crusoe British colonialism began in the early fifteen hundreds and even continues today with the British rule of the British Virgin Islands. For centuries, literature has served as a type of historical documentation of colonization as many authors wrote about colonization from both a colonized and a colonizers point of view. During colonization, and post-colonization, the physical environment of each colony was changed. Using references to A Small Place, A Passage to India, and Robinson Crusoe, I will provide examples of the physical changes to the colonized societies made by England and discuss the reactions of the colonized people.†¦show more content†¦Finally, Kincade makes reference to the schools the British built, You loved knowledge, and wherever you went you made sure to build a school... (Kincade 94). Although Kincade tells us what the British built while in Antigua, she does in such a way she expresses her discontent all the while giving us the good things they did. On t he contrary, in an interview with Kincade she described the library with fondness. She even expressed her discontent for her homeland because they did not attempt to rebuild the library after it had been destroyed. Kincade gives us reference to the physical changes England made while in Antigua. However, she seems to have mixed feelings toward these changes. Another writer, E.M. Forster, also gives examples of the English built England everywhere. In his book, A Passage to India, one of the main characters, Aziz is describing Mr. Fieldings (an Englishman) house as he observes while visiting for tea. Aziz describes the high ceilings and the archways commonly associated with British architecture. He continues by describing the beautiful light blue color and the openness of the room, It was also a very beautiful room, opening into the garden through three high arches of wood. (Forster 66). But Aziz was mostly impressed with ...the carving on the pavilions. Think of the hours it took. Their little roofs are curved to imitate bamboo. So pretty... (Forster 75). The architecture Aziz was so impressed with was typical