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Dealing with Difficult Times

Dealing with Difficult Times

In today’s complex world, many of us find ourselves feeling stressed, with demands coming at us from many directions. Whether a person’s source of tension and anxiety are being influenced by personal issues or larger “world” issues, having coping strategies that help us feel like we are “doing” something can have a positive effect on our overall well-being

 

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The Center for Indigenous Nursing Research for Health Equity

The Center for Indigenous Nursing Research for Health Equity

Creating opportunities for nurses and giving respect to tradition

By Elizabeth Moore

With the stirring music and sacred smoke of a traditional Native American blessing, the first indigenous nursing research center in the world was dedicated in May 2017 at the Florida State University (FSU) College of Nursing in Tallahassee, Florida. Led by Executive Director John Lowe, PhD, RN, FAAN, the Center for Indigenous Nursing Research for Health Equity (INRHE) aims to attain health equity through research, education, and service by partnering with indigenous peoples, communities, organizations, and supporters globally.

center indigenous nurse research health equityLowe, who is the McKenzie Endowed Professor for Health Disparities Research at FSU, envisions the center developing “a strong unity among global nurses” who are working to increase health equity in native communities. Lowe has spent his career exploring health disparities and inequities in indigenous communities and studying cultural practices and traditions that have proven helpful in alleviating the effects of those disparities.

Health equity goes further than eliminating health disparity. “Just because we reduce disparities [in indigenous populations] doesn’t mean we are optimizing health,” said Lowe, a Florida Nurses Association member. “As indigenous or Native American people, we believe health equity is an inherent right,” he explained. “Our ancestors sacrificed land, lives, and culture so that their descendants could have what was promised through treaties and other means. But we were left with inequities and disparities. This context is important to why we strive for health equity.”

The estimated worldwide population of indigenous people is 370 million; they belong to 5,000 different groups and speak about 4,000 languages. The INRHE center currently has projects in collaboration with multiple tribes in the United States and is developing projects with indigenous communities in Canada, Australia, Panama, and New Zealand.

Lowe would like to see the center build relationships with other health disciplines. And, he said, “We want to be a hub, not just for indigenous nurses, but for other nurses who know the issues.” Connecting with indigenous populations globally also is critical, as they share common experiences with colonization and dispossession, he noted.

The center hosted the first International Indigenous Nursing Research Summit in May 2017. To ensure a broad array of viewpoints, the center’s advisory board council is made up of indigenous and nonindigenous scholars from around the world.

Advisory Council Member Odette Best, PhD, RN, associate professor of nursing and midwifery at the University of Southern Queensland, called the summit the most empowering indigenous health conference she’s ever attended. “This was due to Professor Lowe’s ability to pull together global, indigenous nurses to present our research to fellow indigenous nurse researchers,” said Best, who is an Aboriginal Australian.

Traditions and clinical practice can coexist

center indigenous nurse research health equity summitA Cherokee Native American, Lowe is one of just a few Native American male RNs and was honored in 2016 with the American Nurses Association’s Luther Christman Award, which recognizes the achievements of men in nursing. While earning his BSN, MSN, and PhD, Lowe worked in clinics and provided nursing instruction around the United States and in Tanzania, China, Jamaica, and Costa Rica. He has received funding from the National Institutes of Health for his work on Native American substance abuse prevention, including an after-school substance abuse prevention intervention called the Intertribal Talking Circle, which has been acknowledged by the U.S. Department of Justice’s Office of Justice Programs as a Promising Evidence-Based Program for the well-being of youth.

The Talking Circle is an example of the culturally congruent interventions that INRHE center researchers will focus on. “Healthcare professionals should learn more about [indigenous or native] practices and learn to work with them,” Lowe said. “If a native or indigenous person were to present themselves in a healthcare setting and report that they were using a traditional medicine, how would the healthcare provider assess that respectfully?” Increased education about indigenous practices furthers understanding and can prevent potentially unsafe interactions. For instance, “If a native person is using some kind of traditional plant, [the healthcare provider] needs to be knowledgable about that” to avoid potentially unsafe interactions, Lowe explained.

center indigenous nurse research health equity culturally congruent practiceIn 2015, a new standard of professional performance, Standard 8: Culturally Congruent Practice, was added to the third edition of the American Nurses Association’s Nursing: Scope and Standards of Practice, which is in accord with how Lowe hopes the INRHE center’s work will translate into practice.

Competencies for RNs at all levels include:

  • participates in lifelong learning to understand cultural preferences, worldview, choices, and decision-making processes of diverse consumers
  • applies knowledge of variations in health beliefs, practices, and communication patterns in all nursing practice activities
  • promotes equal access to services, tests, interventions, health promotion programs, enrollment in research, education, and other opportunities.

Additional competencies are delineated for graduate-level prepared RNs and include “develops recruitment and retention strategies to achieve a multicultural workforce.” Similarly, additional competencies are specified for advanced practice RNs, including “promotes shared decision-making solutions in planning, prescribing, and evaluating processes when the healthcare consumer’s cultural preferences and norms may create incompatibility with evidence-based practice.”

center indigenous nurse research health equity minority fellowship“Nurses in indigenous communities around the world are delivering most of the health care. It only makes sense that nurses act as the catalyst for research,” Lowe said. He sees nurses researching particular health problems in specific communities and how traditional living and healing practices are working— and how they might complement evidence-based interventions.

Increasing opportunities

Melessa Kelley, PhD, RN, is one of the center’s postdoctoral fellows. Her current research focuses on obesity prevention among Native American youth.

center indigenous nurse research health equity melessa kelley

“The center has provided me with many amazing opportunities to network with nurse scientists around the world,” said Kelley, who has presented her research at several conferences. Last summer, she was the only Native American selected to attend the National Institute on Minority Health and Health Disparities (NIMHD) Health Disparities Research Institute (HDRI) as a Research Scholar, where she learned about innovative approaches to research and grant opportunities that address health disparities. Kelley believes collaboration via the center will continue to elevate health equity research.

Although part of the center’s purpose is to educate nurses and healthcare providers about the needs and characteristics of indigenous populations, it also serves to help increase the number of Native Americans who are PhD-prepared nurses. Lowe said he wants the center to provide “great research experiences” as well as opportunities for connection and networking. He hopes that fellows of the Minority Fellowship Program of the ANA see the center as a place where they can gain experience working with indigenous people and launch post-doctoral careers.

Elizabeth Moore is a writer at ANA.

 

March 2018 Frontline

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Stopping acute upper-GI bleeds

Stopping acute upper-GI bleeds

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The imperative of humble leadership

The imperative of humble leadership

By Donna Grande, MGA

Empower your team through shared responsibility.

In this world of social media, where people focus on self-promotion, it seems odd to address the issue of humility. But humble leadership is imperative in today’s world. Humble leaders are critical for creating environments that enable diversity of thought and ideas. They create space for others to contribute by demonstrating acts of humility, empowering others to learn and grow, taking risks for the greater good, and holding people responsible for results. Engaging in different points of view is often contrary to what you might expect of leadership, but dialogue is far different from debate—and true humility is demonstrated when leaders suspend their own agenda and beliefs to truly hear another point of view.

Acknowledging others’ opinions and ideas shows strength and competence, and that you’re not threatened by others’ valuable contributions. When people feel valued, they’re more productive, which creates a positive atmosphere. Humility also stimulates professional growth as you become more self-aware, acknowledging that you can’t do it all; none of us is infallible, and we need others to learn, grow, and be successful. A 2011 study found that admitting mistakes, highlighting follower strengths, and modeling teachability are at the core of humble leadership and are powerful predictors of an organization’s growth.

Humility doesn’t imply weakness. On the contrary; it enables you to be gentle but strong, forgiving, and appreciative. As a humble leader you share authority and responsibility, investing in others to build new leaders, taking risks in them, and trusting them with the vision.

Shifting to self-less

imperative humble leadership We also see humble leadership in successful entrepreneurs who have the self-confidence, dynamism, and tenacity to start and build a successful venture but may not have the acumen to run it, according to entrepreneur Richard Branson. Shifting from “self” to “self-less” is a critical part of the transition that empowers a team and enables an organization to operate smoothly and effectively. “The entrepreneur’s job is effectively to put themselves out of a job each time the new company is up and running,” Branson wrote. Clearly a tenet of humility.

A type-A, action-oriented, high-achiever may shudder at the terms “servant leader” or “humble leader,” but studies show the power and influence these styles have on an organization. Humility is about honesty; it helps cut through the ego to overcome conflicts and create harmonious situations.

“People with humility do not think less of themselves; they just think about themselves less,” explains management expert Ken Blanchard. Nurses regularly show humility—putting patients at the center of care and often before their own well-being. And, according to the American Nurses Association’s Code of Ethics for Nurses with Interpretive Statements, “The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.” You can’t get more humble than that.

Donna Grande is vice president of products and services at the American Nurses Association.

Selected references

Blanchard K, Johnson S. The New One Minute Manager. New York City: William Morrow; 2015.

Branson R. Business Stripped Bare: Adventures of a Global Entrepreneur. London: Virgin Books; 2010.

Prime J, Salib ER. Inclusive Leadership: The View From Six Countries. New York: Catalyst; 2014.

Prime J, Salib, E. The best leaders are humble leaders. Harvard Business Review. May 12, 2014.

University at Buffalo. Humility key to effective leadership. ScienceDaily.com. December 9, 2011.

 

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Comparing Pathway to Excellence® and Magnet Recognition® Programs

Comparing Pathway to Excellence® and Magnet Recognition® Programs

Two roads to nurse engagement and quality outcomes.

Takeaways:

  • Magnet recognizes healthcare organizations for quality outcomes, patient care and nursing excellence, and innovations in professional practice
  • Pathway emphasizes supportive practice environments, including a established shared-governance structure that values nurses’ contributions in everyday decisions, especially those that affect their clinical practice and well-being.

By Christine Pabico, MSN, RN, NE-BC, and Rebecca Graystone, MS, MBA, RN, NE-BC

Creating a supportive practice environment fosters sustained excellence and inspires innovation. Nursing leaders recognize the benefit of the American Nurses Credentialing Center’s (ANCC’s) organizational credentials from the Magnet Recognition Program® (Magnet®) and Pathway to Excellence® (Pathway). Both programs provide valuable frameworks for achieving healthcare excellence that reinforce and build upon each other. Many organizations have used Pathway and Magnet frameworks to successfully improve a host of key measures, including nurse engagement, nurse retention, interprofessional collaboration, patient safety, quality, and outcomes.

But how do the two programs compare? Magnet and Pathway are two distinct programs with a complementary focus. Magnet recognizes healthcare organizations for quality outcomes, patient care and nursing excellence, and innovations in professional practice, while Pathway emphasizes supportive practice environments, including an established shared-governance structure that values nurses’ contributions in everyday decisions, especially those that affect their clinical practice and well-being. This environment promotes engaged and empowered staff, an essential foundation for every organization. (See Pathway and Magnet—Providing standards for excellence.)

compare pathway excellence magnet recognition program standard

Achieving recognition

Both Pathway and Magnet recognition have a four-phase process: online application, document review, validation phase, and designation decision.

After healthcare organizations apply and are determined to meet eligibility requirements, they submit written documentation that undergoes rigorous peer review by expert appraisers. The validation phase varies by program. If the written documentation for Magnet recognition meets the threshold for nursing excellence, a site visit is conducted to validate, verify, and amplify compliance with and enculturation of the Magnet® Model components. For Pathway, instead of a site visit, all nurses have a voice through an invitation to participate in a confidential survey during the validation phase.

The final phase is a designation determination by the Commission on Magnet Recognition or Commission on Pathway to Excellence.

Work environment

compare pathway excellence magnet recognition program leadershipBoth Pathway and Magnet include standards and components related to the work environment. (See Influential leadership.)

Magnet addresses the work environment through the Magnet Model component Structural Empowerment, which fosters RN involvement in shared governance, decision-making structures, and processes that establish standards of practice and address opportunities for improvement. In addition, both Magnet and Pathway nurses support organizational goals, advance the profession, and enhance professional development through their work with professional and community groups.

Unique to Pathway is the well-being standard, which encourages staff to have a voice in organizational initiatives developed to promote work-life balance. Flexible scheduling and input into staff­ing, part of the well-being standard, are associated with increased job satisfaction and decreased intent to leave. Nurses are encouraged to be involved in the community, and they’re recognized for their contributions to improving population health. Practice environments that foster praise and recognition, another important Pathway component, positively impact nurses’ satisfaction and organizational commitment. In addition, Pathway organizations promote a culture of lifelong learning to ensure the professional competency and growth of all nurses.

Professional practice

Several unique Magnet Recognition components—Empirical Outcomes, New Knowledge, Innovations and Improvements, and Exemplary Professional Practice—demonstrate nursing excellence. Empirical Outcomes, a component that differentiates Magnet from Pathway, is one way Magnet recognizes cultures of excellence and innovation. For example, Magnet-recognized organizations must demonstrate excellent patient care outcomes, including lower rates of patient falls with injury, central line–associated bloodstream infections, and stage II or higher hospital-acquired pressure injuries.

compare pathway excellence magnet recognition programPathway to Excellence emphasizes supportive practice environments that promote engaged and empowered staff. Pathway evaluates nurses’ participation and involvement and considers how this has resulted in improved outcomes.

Magnet organizations build on positive practice environments that support exemplary professional practice. The care-delivery system is integrated within this model and promotes continuous, consistent, efficient, and accountable delivery of nursing care.

In addition, nurses in Pathway and Magnet-recognized organizations learn about evidence-based practice and research. Nurses in Magnet-recognized organizations systematically evaluate and use published research and generate new knowledge through research studies. This knowledge allows them to explore the safest and best practices for their patients and practice environment.

Framework for excellence

Both Pathway to Excellence and Magnet Recognition programs provide valuable frameworks for achieving healthcare excellence.

Many organizations have used the Pathway and Magnet frameworks to successfully achieve improvements in nurse empowerment, engagement, satisfaction, retention, care quality, and cost savings. By embracing change and innovation, Magnet and Pathway organizations, and those that are on the journey to recognition, are strongly positioned to meet new healthcare challenges and improve the future of healthcare delivery.

The authors work at the American Nurses Credentialing Center in Silver Spring, Maryland. Christine Pabico is director of the Pathway to Excellence Program. Rebecca Graystone is director of the Magnet Recognition Program.

Selected references

Aiken LH, Sloane DM, Clarke S, et al. Importance of work environments on hospital outcomes in nine countries. Int J Qual Health Care. 2011;23(4):357-64.

American Nurses Credentialing Center. 2019 Magnet® Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2017.

Barnes H, Rearden J, McHugh MD. Magnet® hospital recognition linked to lower central line-associated bloodstream infection rates. Res Nurs Health. 2016;39(2):96-104.

Bekelis K, Missios S, MacKenzie TA. Association of Magnet status with hospitalization outcomes for ischemic stroke patients. J Am Heart Assoc. 2017;6(4):e3005880.

Carter MR, Tourangeau AE. Staying in nursing: What factors determine whether nurses intend to remain employed? J Adv Nurs. 2012;68(7):1589-600.

Djukic M, Kovner CT, Brewer CS, Fatehi FK, Cline DD. Work environment factors other than staffing associated with nurses’ ratings of patient care quality. Health Care Manage Rev. 2013;38(2):105-14.

Evans T, Rittenhouse K, Horst M, et al. Magnet hospitals are a magnet for higher survival rates at adult trauma centers. J Trauma Acute Care Surg. 2014;77(1):89-94.

Friese CR, Himes-Ferris L. Nursing practice environments and job outcomes in ambulatory oncology settings. J Nurs Adm. 2013;43(3):149-54.

Friese CR, Xia R, Ghaferi A, Birkmeyer JD, Banerjee M. Hospitals in ‘Magnet’ program show better patient outcomes on mortality measures compared to non-‘Magnet’ hospitals. Health Aff. 2015;34(6):986-92.

Kutney-Lee A, Germack H, Hatfield L, et al. Nurse engagement in shared governance and patient and nurse outcomes. J Nurs Adm. 2016;46(11):605-12.

Lake ET. Development of the practice environment scale of the Nursing Work Index. Res Nurs Health. 2002;25(3):176-88.

McHugh MD, Kelly LA, Smith HL, Wu ES, Vanak JM, Aiken LH. Lower mortality in Magnet hospitals. Med Care. 2013;51(5):382-8.

Melnyk BM, Fineout-Overholt E, Gallagher-Ford L, Kaplan L. The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. J Nurs Adm. 2012;42(9):410-7.

Park SH, Gass S, Boyle DK. Comparison of reasons for nurse turn­over in Magnet® and non-Magnet hospitals. J Nurs Adm. 2016;46(5):284-90.

Stimpfel AW, Rosen JE, McHugh MD. Understanding the role of the professional practice environment on quality of care in Magnet® and non-Magnet hospitals. J Nurs Adm. 2014;44(1):10-6.

Staggs VS, Dunton N. Hospital and unit characteristics associated with nursing turnover include skill mix but not staffing level: An observational cross-sectional study. Int J Nurs Stud. 2012;49(9):1138-45.

Tomey AM. Nursing leadership and management effects on work environments. J Nurs Manag. 2009;17(1):15-25.

Wong CA, Spence Laschinger HK. The influence of frontline manager job strain on burnout, commitment and turnover intention: A cross-sectional study. Int J Nurs Stud. 2015;52(12):1824-33.

 

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Two sides to the opioid crisis

Two sides to the opioid crisis

Anne Fuqua, a former nurse, recently shared her opioid crisis story in the Washington Post. But it’s not the story you might be expecting to hear. Anne isn’t suffering from addiction. Instead, she suffers from pain and spasms caused by dystonia.

Anne can’t take many of the medications typically prescribed for her condition, but, for reasons her doctor can’t explain, she does respond well to opioids. So much so that her body is no longer rigid, her fists aren’t clenched, and her pain is diminished.

However, because of new laws and policies enacted to address the epidemic of opioid addiction in the United States, she’s already experienced the loss of her physician who no longer wants to work in pain management and reduced doses of medication that brought the return of pain and other symptoms.

You can read Anne’s full story here, which will leave you with quite a lot to think about. How do we solve the crisis of opioid addiction but continue to treat patients who truly benefit from these medications?

Source: https://www.washingtonpost.com/outlook/the-other-opioid-crisis-pain-patients-who-cant-access-the-medicine-they-need/2018/03/09/5ad83b24-2301-11e8-badd-7c9f29a55815_story.html?utm_term=.3d152c567fbd

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Splash safety—Protecting your eyes, Part I

Splash safety—Protecting your eyes, Part I

Take the time to protect your eyes from pathogens.

Takeaways:

  • Nurses sustain the largest percentage of blood and body fluid exposures (BBFE) in acute-care settings in the United States.
  • From 50% to 60% of splashes that touch unprotected skin are blood or body fluids visibly contaminated with blood; 83.4% occur to the nurse’s face and 66.7% occur to their eyes.
  • Of those nurses reporting any kind of BBFE, only 8.1% said they were wearing eye protection.
  • Eye protection should be used whenever exposure to body fluids or infectious viruses and bacteria can occur, not just when exposure is likely to occur.

By Amber Hogan Mitchell, DrPH, MPH, CPH and Linda Powell, MSN, RN, FNP

Editor’s note: March is Workplace Eye Wellness Month. In this first of a two-part series on protecting your eyes from splashed body fluids that may contain pathogens, we share insights from two experts: Amber Hogan Mitchell, DrPH, MPH, CPH, president and executive director of the International Safety Center; and Linda Powell, MSN, RN, FNP, workers’ compensation case manager for Scripps Green/Scripps Encinitas in California.

How many nurses are exposed to splashes at work?

Mitchell: Nurses sustain the largest percentage of blood and body fluid exposures (BBFEs) in acute care settings in the United States. According to the International Safety Center’s Exposure Prevention Information Network (EPINet®) national surveillance data from 2012 to 2016, nurses experience a disproportionate number of all splashes and splatters—about 50% (range of 47.7% to 54%) compared to all other healthcare professionals. Almost 60% occur in patient or exam rooms, and about 25% occur evenly distributed between emergency departments and operating rooms. Nurses report that 62.8% of all splashes touch unprotected skin.

From 50% to 60% of those exposures are blood or body fluids visibly contaminated with blood. An unacceptable number of these incidents occur to the nurse’s face (83.4%); of those, 66.7% occur to their eyes.

Although we hear less about splashes than needlestick injuries, nurses experience slightly more splashes at the bedside in patient or exam rooms (the primary settings for needlesticks as well as splashes).

What are the dangers of splashes to the eyes?

splash safety protect eye

Mitchell: Splashes to the eyes can result in transmission of bloodborne pathogens, bacteria, multidrug-resistant organisms, and other microorganisms. Dozens of pathogens, including HIV, hepatitis C virus (HCV), influenza, severe acute respiratory syndrome, herpes B virus, plague, rabies, and Ebola, have been documented to be transmitted via eye exposures. Few facilities do active surveillance for employees, so we can’t estimate how many eye and mucus membrane exposures result in colonization or infection with multidrug-resistant organisms—and how many of these may result in cross-contamination or transmission to patients, co­work­ers, or family members.

One might argue that eye exposures are the riskiest exposure types, potentially resulting in not just pain and injury, but also infection or illness.

Powell: Eye splashes can have damage beyond blood-­borne pathogen exposures. The pH of medications and body fluids can cause corneal trauma and corneal ul­cer­a­tion, resulting in the loss of use of one or both eyes. Virus­es and bacteria—including adenovirus, herpes simplex, Staphylococcus aureus, and rhinoviruses—can be spread to the ocular mucus membrane by splashes, coughing, or touching the area with a contaminated hand or finger.

Do most nurses wear eye protection?

Mitchell: Unfortunately, no. Of those nurses reporting any kind of BBFE, only 8.1% said they were wearing eye protection. The percentage is even lower for exposures specific to the eyes: In 2016, only 1.7% reported they were wearing eye protection when the BBFE occurred, compared to 2012, when 7.3% said they were. Interestingly, in 2016, 62.8% reported BBFEs occurred in a patient or exam room, com­pared to 2012, when 44% were reported in the same location. This may mean that nurses are experiencing more exposures at the bedside and were wearing eye personal protective equipment (PPE) less frequently.

This trend has to be reversed and exposures must be reported and recorded so that they can be addressed and prevented. Organizations should consider incorporating eye and face protection not just into their infection prevention and control caddies, but also as a permanent fixture in patient rooms (either door or wall mounted).

What are the costs of splashes to the organization?

Mitchell: BBFEs are serious business and can have a negative effect on an organization. The effect may be disproportionate in smaller facilities compared to larger ones because a single exposure in a small practice can result in not only disruption of patient care, but also compromised staffing, time away from work, employee turnover, and financial impact. In larger facilities, the organizational impact is different but also substantial (disruption of patient care, an immediate need to shuffle staffing, and costs associated with patient/source and employee baseline testing, postexposure follow-up, and potential prophylaxis).

Cost can range from $800 to $6,000 for a single exposure to $80,000 to $1,000,000 or more if an employee seroconverts to a bloodborne disease such as HCV and needs lifetime treatment. Additional costs can be accrued through workers’ compensation insurance costs and premiums, not to mention potential Occupational Safety and Health Administration (OSHA) fines if an inspection occurs as a result of an employee complaint.

But the greatest expense is emotional. Because of the underlying stigma associated with occupational BBFE and reporting it, employees may not receive the medical care they need after an incident, which may increase their likelihood of becoming ill or seroconverting.

What are the standards regarding eyewear protection?

Mitchell: Although standards from the government and professional associations state the need for eye protection, they’re not sufficiently healthcare focused.

The OSHA PPE Standard (29 CFR 1910.132) includes requirements for eye protection but is focused on phys­ical hazards that may cause injury rather than illness or infection. OSHA’s Bloodborne Pathogens Standard (29 CFR 1910.1030) leaves selection and placement of eye protection up to the employer, based on its exposure assessment. The standard states, “When there is occupational exposure, the employer shall provide, at no cost to the employee, appropriate personal protective equipment such as, but not limited to, gloves, gowns…eye protection [italics added]….” This is why tracking exposures is important, so that the circumstances surrounding them can be documented and appropriate PPE made available to employees.

The National Institute for Occupational Safety and Health states that “eye protection chosen for specific work situations depends upon the nature and extent of the hazard, the circumstances of exposure, other protective equipment used, and personal vision needs.” The Association of periOperative Registered Nurses’ standards on surgical attire include eye protection, and the American Optometric Association website provides guidance for workplace eye safety.

The lack of standard requirements for nurses’ eye protection and the high prevalence of eye exposures compared to all other exposure types make it clear that we have work to do to convince policy makers, legislators, regulators, professional associations, and advocacy groups that we need to create or amend standards to protect nurses.

Powell: The Centers for Disease Control and Prevention recommends eye protection whenever staff may be at risk for acquiring infectious diseases through exposure to the ocular membrane.

splash safety protect eye wearWhen should nurses wear eye protection?

Powell: Eye protection should be used whenever exposure to body fluids or infectious viruses and bacteria can occur, not just when exposure is likely to occur. The rule of thumb is that if you put on gloves, put on eye protection.

Why don’t nurses wear eye protection?

Powell: The two main reasons are lack of availability and failure to establish a habit of wearing it. Eye protection needs to be available at the point of service. If staff have to go outside of the patient room to obtain protection, odds are they won’t do it. To encourage the habit of wearing eye protection, managers must set expectations and provide ongoing education about its importance.

In the second part of this series, Mitchell and Powell will focus on how organizations—and nurses—can reduce injuries from eye splashes.  

This series is supported by an unrestricted educational grant from Tidi Products.

 

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Concept Performance Metrics

Concept Performance Metrics

Concept Performance Metrics

Introduction

Performance metrics determines the activities and operations of the business. Performance metrics in a particular organisation helps to gather information about that organisation. Hence, the stakeholders become aware about the status of the organisation. Food and beverage industry is a vast sector and subjected to tough competition. In order to receive a sustainable growth and success in the business it is important to monitor the performance of the organisation. Performance metrics allows the organisation to perform that task. Through the implication of performance metrics, a business could receive certain advantages. This study is intending to figure out the role of the managers in implementing performance metrics. It also intends to describe the impact of performance management in the success of the food and beverage company. Application of performance metrics has certain advantages along with challenges, which will be discussed in this study.

Concept of Performance Metrics

Performance metrics includes certain factors that help the organisation to comprehend status about the organisation. It includes the behaviour, performance and activities. As stated by Berges et al.(2013), performance metrics include the interest of all the stakeholders and shareholders of the organisation. Implication of performance matrix helps the organisation to determine the status of the business along with its strength and weakness. It helps to determine the strong and weak points of the company, hence, based upon that the management can determine the organisational strategies. Thus, the growth and sustainability of the organisation depends on the successful application of performance metrics.

Role of performance metrics to measure success in food and beverage stores

The key to evaluating the business is by measuring the performance of the employees. This evaluates whether the employees are doing their work properly or not. A performance metrics provide the hard data and yields results that help in measuring the clear quantities to allow development to the food and beverage industry. Performance measurement is required to collect, analyze and report the performance of an individual, group, and organisation. The performance measurement works qualitatively to provide various information about the products, processes, and services that are provided by the company or organisation. Badland et al. (2014) proposed that the performance of measurement must be practiced on a regular basis to check the performance against the standards and quality of the products and services provided by the company. A manager is responsible for the performance metrics. The manager observes controls, supervises the activities of the subordinates, and prepares the reports based on their performance. This helps in managing the various activities to accomplish them effectively. The manager constantly checks the performance of the activities to ensure that activities are performed in a specified manner or if any correction activity is required. On the contrary, if any deviations occur in the work the manager ensures that such deviations are not continued further. Thus, the performance measurement is a process of which is required for continuous improvement.

Concept Of Performance Metrics

For example, Woolworths Limited need to increase its current sale profit by fifteen percent thus, they need to first calculate the break-even point. This value tells the organisation about how much sales they need to make to increase the profit by fifteen percent. Wu et al. (2014) mentioned that the prime cost is the sum total of all the expenditure made by the store. Including the cost of the labour and the cost of the goods, they sold. Whatever money is left back excluding the prime cost is the profit of the store. The prime cost of a store is generally sixty percent of the total sales. To increase the profit margin of the store they need to decrease the extra expenditure and manage the activities properly.

The role of the evaluation mechanism influences the manager. The manager uses the broad-based measurement information for the control and feedback. The resultant decision made by the manager makes an impact upon the identification and exploration of the major and strategic capabilities to improve the organisational performance. Georgiev et al. (2014) commented that the managers to take strategic decisions to increase the performance of the organisation subsequently and to implement the decision-facilitating measures.  The performance of an organisation arises from the decision-making on the exploring the existing capabilities and the identification and implementation of the new opportunities.

The performance metrics not only measures the performance rate of the employees but also the productivity of the entire organisation at a lowered cost. Necessary feedbacks can be generated through this process, which is helpful for the managers to guide the activities accordingly. Thus, it can be said that the performance metrics process is helpful in understanding, managing and improving the business of an organisation.

Different performance metrics

Food and beverage industry is vastly diversified. In order to measure the success of the business in this industry manager applies various key performance metrics. Owners could get information about the present status by monitoring those metrics in regular basis. It depicts both the negative and positive trends of the venture. Some of the key performance metrics have been discussed which play vital role in order to measure the success of the venture.

Break Even Point

Breakeven point is the most important metrics that should be monitored in regular basis in order to comprehend the status of the business. Figures in breakeven point calculation depict the requirement of investment in order to get it back as profit. As opined by Roloff et al.(2012), simultaneously it provides the forecast about the period to earn the money back. In case of both function of starting or investing and business operation, this metrics plays the vital role. It also justifies the additional investment. Through the calculation of breakeven point, one can comprehend the necessity of investment and time to earn it back.

Calculation:

Breakeven point= Total fixed Costs/((Total sales- Total cost of variables)/Total sales)

Hence, it is important to know fixed cost along with total cost and variable cost and also total sales to calculate the breakeven point.

Cost of Goods Sold (COGS)

COGS is another important metrics in order to determine the organisational operation. It depicts the cost behind every item that has been offered to the customers. Hence the organisational authority could decide the cost of the product while sell the product. Thus an organisation could easily figure out the profit or loss while sell the product through COGS calculation. As mentioned by Loderer & Waelchli (2010), it helps to adjust the organisational policies in different market situations and demand. It also assists the organisation to figure out the major sector of expenditure and based upon that the organisation could adopt certain policies to reduce the expenditure.

Calculation

COGS= Purchased inventory+ starting inventory-final inventory.

A store starts with $ 5,000 inventory. The company invest $ 2,000 to purchase and the organisation left with $ 4,000. Hence the COGS of the company will be $ (2,000+5,000-4000), i.e. $3,000.

Overhead Rate

Another important metrics to measure the success of the organisation is overhead rate. It provides information about the operational expenditure. Authorities of the organisation could get information through the calculation of overhead rate about the regular expenditure carried by the store or the organisation in order to continue the venture. Hence, the organisation could get information about service expenditure and could determine the organisational policies to attract additional profit.

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MANAGING FOOD AND BEVERAGE OPERATIONS

MANAGING FOOD AND BEVERAGE OPERATIONS

MANAGING FOOD AND BEVERAGE OPERATIONS

Performance metrics of an organisation is related to several factors. Hence it has certain challenges that put major impact on the organisational performance. According to Sharawi  (2014), organisations often face certain challenges while applying performance metrics.

Reduction in output level

A major challenge of implementation of performance metrics is related to the employee motivation. Performance metrics determine the standards of the employee performance. While the experienced employee could find it unfair to judge their contribution and loyalty through the scale of performance, new employees could find it tough to achieve the standard of the performance with their limited skill and experience, hence both levels of employees are de-motivated by it and as a result the production rate and quality reduce.

Difficulty in communication:

While natural attributes suggests the employees to communicate while facing a challenge in the workplace, performance metrics determine that they should proceed on their comprehension of responsibilities. Hence, the job could strike in certain case of challenge.

Lack of commitment:

Performance metrics determines that the employees should perform according to the determined standard of the performance. Employee valuation depends on their performance. Hence, they could feel it monotonous. This raises the possibility of lack of commitment and loyalty among the employees.

Consider subjectivity:

Performance metrics is such a system that provides important data related to the organizational as well as individual performance. This system is depended on the operator to provide data. Hence, data could be easily manipulated and even taken based on emotion. Thus, the validity of the provided data is not yet above level of question.

Recommendation for successful application of performance metrics

Though performance management provides certain advantages in the context of measurement of organisational success in food and beverage industry, it is also subjected to certain challenges. In order to imply performance management in proper way, it is important to mitigate those challenges. Some of mitigating steps are addressed here.

Clear concept

In various cases a wrong messages has been conveyed to the employees of the organisation regarding the concept of performance metrics. Lack of transparency about the concept creates such challenges. In order to apply performance metrics in a successful way, it is important to define the concept clearly to the employees of the organisation. Only then, it could get proper support to help the success of the organisation.

MANAGING FOOD AND BEVERAGE OPERATIONS

Determine the goals of the process:   

In order to achieve the success through performance management it is important to determine priority of the process. This approach could provide certain advantages in various sectors. Some of them are even contradictory. For example, it may present additional expenses as certain challenges and suggest reducing that. As a result, the business process could be affected. Hence before apply performance management it is important for the organisation to determine the objectives of the system.

Aligned goals:

Instead of determine high level of standards it is important to determine the standards of the performance according to the organisational goals. High level of performance could design the performance standard as very high but may be unreachable for the employees. Hence, the employees will be de-motivated because of the continuous failure to achieve the level. In order to mitigate that challenge it is important to determine the standards according to the organisational goals.

Conclusion

This study concerns about the role of performance metrics in the success of the food and beverage company. This has presented a vivid description about performance metrics. It also presents the role of the managers while implementing performance metrics in the organisation. There are certain performance metrics that are applied by various organisations in order to achieve a sustainable success in the business; those are described in the study. These include COGS, breakeven point, prime cost, overhead rate and others. Application of performance metrics has certain advantages, which are described in depth in the study. Application of performance metrics is subjected to certain challenges. This report has put lights on those challenges and discussed their impacts on organisation’s success. In order to apply performance management successfully in the organisation, it is important to mitigate those challenges. This study also presents some mitigating steps in the context of such challenges. It can be conclude that the application of performance management has certain advantages and challenges and mitigating these challenges could make perfect to determine the success of the business.

References:

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Georgiev, P., Noulas, A., & Mascolo, C. (2014, May). Where businesses thrive: Predicting the impact of the olympic games on local retailers through location-based services data. AAAI. Retrived on 26/10/2017 from “http://www.aaai.org/ocs/index.php/ICWSM/ICWSM14/paper/download/8071/8115

Hernández-Orallo, J., Flach, P., & Ferri, C. (2012). A unified view of performance metrics: translating threshold choice into expected classification lossJournal of Machine Learning Research13(Oct), 2813-2869. Retrieved on 20 Oct, 2017, From: http://www.jmlr.org/papers/volume13/hernandez-orallo12a/hernandez-orallo12a.pdf

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Kumar, U., Galar, D., Parida, A., Stenström, C., & Berges, L. (2013). Maintenance performance metrics: a state-of-the-art review. Journal of Quality in Maintenance Engineering19(3), 233-277.Retrieved on 20 Oct, 2017, From: http://www.diva-portal.org/smash/get/diva2:1000348/FULLTEXT01.pdf

Loderer, C. F., & Waelchli, U. (2010). Firm age and performance. Retrieved on 20 Oct, 2017, From: https://mpra.ub.uni-muenchen.de/26450/1/MPRA_paper_26450.pdf

Roloff, E., Diener, M., Carissimi, A., & Navaux, P. O. (2012, December). High performance computing in the cloud: Deployment, performance and cost efficiency. In Cloud Computing Technology and Science (CloudCom), 2012 IEEE 4th International Conference on (pp. 371-378). IEEE. Retrieved on 20 Oct, 2017, From: https://www.researchgate.net/profile/Matthias_Diener/publication/261389348_High_Performance_Computing_in_the_cloud_Deployment_performance_and_cost_efficiency/links/546239b40cf2837efdaff3a7.pdf

Sharawi, M. S. (2014, February). Printed MIMO antenna systems: performance metrics, implementations and challenges. In Forum for Electromagnetic Research Methods and Application Technologies (FERMAT) (Vol. 1). Retrieved on 20 Oct, 2017, From: https://www.e-fermat.org/files/articles/15337272d22a9a.pdf

Wu, P. H., Huang, C. Y., & Chou, C. K. (2014). Service expectation, perceived service quality, and customer satisfaction in food and beverage industry. International Journal of Organizational Innovation (Online)7(1), 171. Retrived on 26/10/2017 from

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Safe Use of Restraints

Safe Use of Restraints

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