Deca Commissary - Providing Customer Confidence Research Paper

Deca Commissary - Providing Customer Confidence - Research Paper Example In this case, the commissaries ensure that the personnel and their families obtained goods at prices that saved them approximately 30percent the cost that civilians bought similar products (Skirbunt & Robinson, 2008). While the practice started long before organizations realized the important role of integrating customer’s needs in an organization, DeCA realizes the importance of integrating modern era practices that will ensure that the commissaries created customer confidence. First, it is important to point out that the core competency of commissary benefits were customers’ savings, which is also the main reason for its existence (Skirbunt & Robinson, 2008). In effect, DeCA works towards ensuring that the upholding and maintenance of these key competencies of the commissaries. In line with this, DeCA has integrated technology in its facilities to ensure that products offering were the same throughout their facilities. In addition, technology ensures that all facilities had enough stock and the replenishment of stock was timely since technology ensured that the supply of products was always constant with the facilities always stocked. It is evident that one way of ensuring customer satisfaction was ensuring a constant supply of goods and services. In effect, an organization that ensures customer satisfaction enhances the level of confidence amongst its customers. Therefore, ensuring constant supply of products in all is commissaries ensured that De CA created customer satisfaction, which led to establishing customers’ confidence in all its facilities. In the modern world, the safety of products is a key factor that determines the development of customers’ confidence in an organization. In line with this, Skirbunt and Robinson (2008) noted, â€Å"Food familiarity and safety were also key to success with commissary customers able to shop with

Spaghetti and sausages Essay Example for Free

Spaghetti and sausages Essay This schedule is my average exercise per week. By following this schedule I can assure myself that I do at least five hours of exercise a week because I always walk to and from school. I can also guarantee that I will do an hour and a half of football training on a Wednesday and play the match on a Sunday even in the close season because I play for a summer team as well. My fitness is no longer jeopardised by injury as it was earlier in the year when I broke my right fibula and tibia during a football match. For my main stage fitness test I did:  A bleep test A bleep test is when you run from distance back to another repeatedly. I finished the bleep test with a score of 11.5  Cooper Run the Cooper run is when you run for twelve minutes around a 100 metre circuit without stopping. My number of laps was 27 which means that I did 2700 metres of running.  Harvard step test this is where you put one foot on a bench followed by another then take one foot off and take the other foot off. My pulse rates were:  Compared to the other people that are in my group I am a very fit person. This is because I do a lot of fitness training out of school and I need to keep myself in good shape because I have a strong passion for football. However, nobodys perfect and I am no exception. I feel that I can improve my balance because I often lose it at vital and unexpected times. What Would I like to Achieve?  The sport that I am going to improve my fitness for is football.  The different components of sport in order to play football are:  1) Speed You need this to outpace the opposition players with or without the ball.  2) Power Jumping to head a ball and the power in your leg muscles to kick the ball as hard as you want.  3) Agility Being able to move freely and turn with the ball when sharp movements are needed. 4) Flexibility When you stretch your leg or arm (goalkeeper) to reach for the ball.  5) Stamina Allowing you to last longer on the pitch without getting tired.  6) Strength The ability to outmuscle your opponent for the ball.  7) Balance Being able to stay on your feet in any situation with control over your body.  8) Co-ordination Needed for judging the flight of a ball and when you are in control of it so that you always know where the ball is. The thing in which I would like to improve is my strength. This is because for a footballer, you need to be strong and this is an area in which I am very weak. I will also work on my balance a little because sometimes I find myself falling over when running with the ball at speed.  How am I going to achieve this?  In order to improve my football skills and in particular my strength and balance, I will create a circuit with about eight stations designed to improve my overall skills in football. Over the six weeks the toughness and length of exercise will increase. My body will adapt to the training and my fitness level will slowly rise because my body will get used to the routine. I can do this by increasing the number of repetitions, adding more stations or even reducing the rest periods. My circuit will be completed 3 times a week and the results would be shown by measuring the heart rate of myself in a results table for each week. My circuit plan can be found on the next page followed by a diagram on the page next to that. Week 1 In the first week my heart rate worried me a little because at the start of the second session it raised and after the first session I expected it to be the same. This however was soon put to the back of my mind as on the third session it was back down to 68BPM and on the third session I found out that I had begun to improve my fitness because my heart rate after the exercise session was lower than the previous two sessions. Week 2 This week was another step closer to getting fitter as my third session of the week proved to be an improvement because my heart rate managed to stay the same as the second session. The after exercise heart rate showed me that I continued from the first week but the second session showed that I was not getting my heart rate back down to 71BPM. Like the first week I continued with the third session and I had been shown that I was not only back to where I should be but I improved yet again. Week 3 In week 3 I ended with an even lower heart rate of 66BPM. The second session showed me that my heart rate was one beat more than I expected but this has seemed to be a trend in my results. After 3 minutes of exercise I found my results worrying as I didnt make any improvement at all and in the first two sessions I got worse and worse but luckily was back at 70BPM by the third session. Week 4 This was a disappointing week for me and I clearly was slacking in my programme. My heart rate before exercise stayed at 66BPM for the duration of the week and my after exercise heart rate was higher and this stayed like this, as at the end of the week my heart rate 3 minutes after exercise was 71BPM whereas the week before it was 70BPM. Week 5 After the first session of week 5 I thought that I must have reached my maximum fitness level because it was still 66BPM but then realised over the next two sessions I could still improve as I had heart rates of 65BPM. My after exercise results also finally improved from 71BPM to 69BPM. This was a pleasing week for me as I used the overload tactic to get my heart rate down. Week 6 Finally my six week training program had come to an end. Pleasingly I made a final improvement and my final heart rate before exercise was 64BPM. Another thing that made me proud was that my heart rate 3 minutes after exercise had also improved and that ended with a final rate of 68BPM. Overall I improved my fitness by 4BPM.

Reflecting on Competency with Subcutaneous Injection Technique

Reflecting on Competency with Subcutaneous Injection Technique The focus of this essay will be to select one clinical skill in which I am developing competence in and reflect upon how to achieve the necessary level of competence for this stage of the programme. For the purpose of this essay I have chosen to focus on subcutaneous injections technique as my clinical skill. The nursing and midwifery councils (NMC) Standards for Medicines management states that administration of medicine is not solely a mechanistic task to be performed in strict compliance with the written prescription other medical practitioner. It requires thought and the exercise of professional judgement. In order to perform safe practice it is essential to possess sound knowledge of the anatomy, patient assessment and nursing interventions and methods used are evidence based. (NMC 2007). My rationale for selecting subcutaneous injections (SC) was whilst on my first placement based on a surgical ward this was a widely used skill, which was performed on many occasions. This technique was mostly used for the administration of an anticoagulant (tinzaparin sodium) also know as heparin, given to patients in order to prevent harmful blood clots forming in veins following an operation. Heparin works by changing the way blood clots, allowing blood to flow smoothly through the vessels. (REF) Whilst giving an injection was once the role of the doctor, since the invention of penicillin in 1940s it became the activity of the nurse (Workman 1999). Administering injections is an important part of drug administration and a regular, common place activity for the nurse which unfortunately can easily become a complacent task; the technique should be mastered with a sound knowledge base. Injections are used to distribute medication through a needle or syringe. SC injections are administered for various reasons; these include slow distribution into the body, good absorption due to intramuscular tissue containing small blood vessels and unable to take orally because medication would become inactive by stomach acid. Workman (1999) suggests taking four considerations when administering injections; the site of administration, technique used, equipment used and the route to be used. The choice of the site of injection is based on sound clinical judgement, best evidence and patient assessment (Potter 2010). Site selection is normally upper arm, abdomen or thigh. (Lister Dougherty 2008) suggests upper arm as a most favourable choice as they contain fewer large blood vessels and less painful sensations, however in practice the abdomen is a more common site for heparin as the skin contains a thicker subcutaneous tissue (Hunter 2008).It has been expressed that rotation of sites can decrease the likely hood of irritation and ensure improved absorption (Dougherty and Lister 2009). Traditionally the technique used when administering subcutaneous injections has been using a 45degree angle into a raised skin fold, however since the introduction of shorter needles and pre filled syringes this has been challenged and it is now recommended that the injections are given at a 90 degree angle into a raised skin fold to ensure medication is given into the SC layer. (REF) The manner to which a medicine is administered determines the extent to which a patient gains clinical benefit. Nurses are responsible for the correct administration of prescribed drugs to patients in their care at all times. Standards for medicine management (NMC 2008a) Adopting a skilled injection technique may make the patients experience less painful and prevent unnecessary complications, whereas poor understanding of the technique could result in the injection being administrated intramuscular which could affect the rate of absorption and cause potential harm to the patient (Hunter 2008). SC injections involve depositing medications into the loose connective tissue underlying the dermis, this tissue is not a richly supplied with blood vessels as muscles are thus allowing the medication to be absorbed slowly. Prior to administering a SC injection the following precautions must be followed: a patients pre-existing condition must be assessed to prevent contraindications, patients prescription chart checked to check correct route, correct dosage of medication, expiry date, hands washed with soap and water to prevent infection, positive patient identification then record the administration on the appropriate chart to avoid any duplication of patients treatment (Dougherty and Lister 2009) The Royal Marsden Hospital Manual suggests that before administering injections the skin should be cleansed with an alcohol wipe for 30 seconds and allowed to dry in order to prevent any contamination, However it has been questioned that the alcohol in the wipe was causing irritation to the skin or prolonged use may cause skin hardening (Hunter 2008). The local trust do not recommend the use of any skin preparation prior to administering SC injections, however aseptic technique to be maintained and as with all patient contact gloves must be worn (Pratt et al 2007) Disposal of the used injection is extremely important to prevent needle stick injuries, a needle should never be re-sheathed; the most frequent route of exposure to blood-borne diseases for health care workers is from needle stick injuries (Potter 2010). The clinical environment is a never ending source of potential learning experiences that become more meaningful the more you participate. (Sharples 2009) The NMC will only accept that a nurse is competent if they are a competent learner (NMC 2004) Evidence Based Practice (EBP) is a systematic approach adopted by nurses to provide a rational decision making that facilitates achievement of best practices often achieved by obtaining the strongest available evidence whilst applying patient care (Potter 2010). EBP is implemented because it allows the highest quality of care and resulting in the best patient outcome (Melnyk and friecut-overholt 2011) The NMC (2008) states that patients have the rights to have a safe environment and staff has a duty to protect patients in maintaining knowledge based practice and continuing with their lifelong learning. I realised in order to be able to become a competent nurse in the future I would need to recognise the type of learner I am and be able to reflect upon this. If I am unaware of my strengths and weaknesses, it is more likely I will be unable to help others (Burnard 1992). Self-awareness and analysis are key component in reflection, and reflection is an essential skill which needs to be acquired, developed and maintained; being self- aware allows us to take control of the situations we find ourselves in, thus becoming less vulnerable (Wilding 2008). There are four different learning styles identified these are; Activists, Pragmatist, Reflector and Theorist. Activists immerse themselves in new experiences, using their enthusiasm to flourish on new challenges. Pragmatists are thought to be practical, putting thoughts, theories and techniques into practice. Reflectors like to take a step back and observe, collecting and analysing information about events and experiences, often slow to reach a conclusion. Theorists on the other hand have a tendency to to favour the facts and are not content on things which dont seem rational (McGill and Beaty 1995) I discovered my learning style was the Activist, although I felt I possessed a few of the other characteristics in the other styles. I enjoy learning most by doing the task at hand and witnessing things rather than reading about them. Bremer (1984) advocates the preferred method of learning is by observing role models, this is often displayed whilst on placement observing mentors carrying out tasks before they allow the student to attempt it for themselves. According to Boud (1993) reflecting on personal experiences plays a major factor in developing to a higher level. Brenner (1984) agrees by suggesting nurses develop to become experts by taught knowledge, by applying the intuition and experience through work practice, however, not all nurses will become experts. In order to develop my learning fully I recognised the need to start completing a reflective diary, recording experiences good and bad, strengths and weaknesses in order to improve my performance. Reflecting on experiences allows us to learn from them and how to improve on them to increase patient care. I am often told by nurses who have been qualified for many years that they often reflect on various situations and if they could have responded to a situation more differently and more effectively. Frazer and Greenhalgh (2001) states that capability is the extent to which the individual can apply, adopt and synthesize new knowledge from experiences and continue to improve performance. The World Health Organisation (WHO 1998) identifies competence as the ability to carry out a certain professional function which is made up of a repertoire of professional practice. Schon identifies two particular types of reflection, a reflection on action and a reflection in action. Reflection in action takes place in practice and may influence future decisions and outcomes, whilst reflection on action traditionally occurs in educational settings either clinical areas or in the classroom (Hinchliff et al, 2008). Ghaye et al (1996) believe that without reflection it is almost impossible to improve in practice. Understanding your own individual learning style is extremely interesting and considered invaluable in developing the ability to learn and partake in learning experiences, and especially important whilst on placement (Sharples 2009). By gaining personal insight and understanding it may help us understand others better (Burnard 1995) An essential part of learning is to seize any learning opportunity that may be presented, a student must show willing, motivated and recognise they are responsible for your own learning. If you as a student present yourself as unmotivated, it will be unlikely that your mentor or others will be motivated to encourage your learning (Sharples 2009). Learn through experimental learning on clinical placement and insightful learning in uni Strategic approach to learning (Kolb 1984)

King Lear And The Fatal Flaw :: essays research papers

‘How central is the idea of a ‘fatal flaw’ in King Lear?’   Ã‚  Ã‚  Ã‚  Ã‚  More than any of Shakespeare’s plays, King Lear explores the concept of a fatal flaw and the terrible downfall it could lead to. It is indeed the most central idea in the play. Shakespeare shows us how one flaw in an otherwise normal person can lead to their ultimate demise.   Ã‚  Ã‚  Ã‚  Ã‚  From the very inception we witness what Lear’s fatal flaw is - his pride. We first see it surface when he decides to divide his Kingdom into three for his three daughters. To claim their share, they must proclaim their love for their father in front of the entire court. Whichever loves him the most will be given the most land. The eldest, Goneril, protests her undying devotion and is given a third of the Kingdom. The second, Regan, does the same and gets another third, but the youngest, Cordelia, is stopped by her honesty. Cordelia does love her father dearly, and knows why her sisters spoke as they did, but is not prepared to take advantage of her ignorant father’s pride simply to bring her land and power. Lear’s reaction to this can be likened to that of a spoiled child and in his fury, divides the rest of his Kingdom between Goneril and Regan, and casts Cordelia away from him. ‘Hence, and avoid my sight!’ A fundamental part of Lear’s mistake is what he expects to hear from his daughters, especially his favorite, Cordelia.   Ã‚  Ã‚  Ã‚  Ã‚  With Cordelia cast away, he sets about trying to enjoy his old age, but we discover that his two eldest daughter’s intentions are not as entirely wholesome as we once thought. When Lear himself learns of this, what he ought to really feel is fear, but what actually possesses him is rage. The King and his fool are thrown out into the stormy night.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"You unnatural hags,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  I will have such revenges on you both that all the world shall -   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  I will do such things,†   Ã‚  Ã‚  Ã‚  Ã‚  Lear is going mad, but knows more than he once did. Not only does he come to realise what he has done, but also on what a cruel and reasonless basis the world punishes.

Biography of Martha Rogers

Born on May 12, 1914, Martha Elizabeth Rogers shares the same birthday with Florence Nightingale. Her passion for nursing persisted in 1933 and she received the degree in 1936. Although this was not her first line of choice in pursuit of a career, still she managed to enter a nursing school at Knoxville General Hospital. Her continuing desire in the nursing field had given her several achievements in different schools. For one, she attained a Bachelor of Science Degree in Public Health Nursing at George Peabody College in Nashville, subsequently becoming a Public Health Nurse at the University of Michigan in 1937. She continued her professional studies of Master’s Degree in Teacher’s College Columbia University New York. Soon after, she became a public health nurse in Hartford, CT afterwards, an acting Director of Education. After having a good position in her job as the Executive Director of the first Visiting Nurse Service in Phoenix, AZ, she further fortified her knowledge at Johns Hopkins University in Baltimore, MD in 1951. In 1954, Martha Rogers took the place of Head of the Division of Nursing at New York University and edited a journal called Nursing Science in 1963. There were certain affirmations that during this time Rogers were already formulating ideas for her third book An Introduction to the Theoretical Basis of Nursing (cited in Rogers, 1970). For 21 years, Rogers served as the Professor and Head of the Division of Nursing. Although she retired from service, she continued to serve her role in the development of nursing and of the ideology concerning the Science of Unitary Human Beings until her passing on March 13, 1994 (Martha E. Rogers: A Short Biography, 2008). Science of Unitary Human Beings Dramatically, the progress of Science of Unitary Humans Beings occurred in Europe. Some of the aspects of that improved are the nursing process, quality assurance, primary nursing, and nursing models included in the theory. However, the prevalent progress does not exhibit its full nature rather remains obscure. Primarily, the principle of Martha Roger’s theory is based on non-predominant aspect of nursing practice, research, and education. According to Smith (1989), Rogers’ perspective on nursing practice is â€Å"guided out of a concrete, static, closed system world view.† In other terms, it is seen as reductionistic, analytic, and mechanistic (Biley, 1990). These ideologies did not prevail as traditional means to deliver care but challenged nursing preexisting ideas. Moreover, the ideology of Roger’s has been at a perspective contradicting the overall aspect of care. Mainly, the Science of Unitary Human Beings covers a vast array of subjects from anthropology, mathematics, astronomy, Einsteinian, and philosophy. Hence, many believe that Rogers concept demand a wider range of knowledge incomparable to what Nursing has. They call it an â€Å"outrageous nursing theory† (cited in Thompson, 1990) because its complexity derives those to difficult comprehensive ideology. Nonetheless, Martha Rogers is vied as a genius, as she is referred to as â€Å"a brilliant nurse theorist† and â€Å"one of the most original thinkers of nursing.† (Daily et al., 1989). Significantly, the foundation of Rogers concept, seen in her 1970 book, lays five basic assumptions on man and his life processes. First is Openness, wherein a human being perceived as a whole is a sum more than different of the other parts. Second is Unidirectionality, describing life processes occurring in an irreversible space-time continuum. Third is Pattern and Organization that characterizes individuals through progressive reflection of their entirety. Finally, is Sentience and Thought, which speaks of life, particularly human beings, capable of abstraction and imagery, language and thought, and sensation and emotion (Rogers, 1970). Notably, the theory expanded into the four critical elements, namely energy fields, open systems, patterns, and pandimensionality (cited in Rogers, 1986). Initially, energy fields were described as â€Å"fundamental unit of the living and the non-living† comprised of the human and environment energy field. Consequently, the human field is irreducible, indivisible, and has a pandimensional energy identified by pattern but is specific to whole (cited in Rogers, 1991). On the other hand, the environmental field is expressed as integral with the human field. In effect, environmental field specifies itself with the human field. Subsequently, there is Rogers’ Open systems critical element. In this area, it is described that the open nature of fields is where the interchange of energy and matter exists. In other terms, there is a continuous process inside regardless of energy and matter. The third element is Pattern, which gives insight to the characteristic of the energy field uniquely perceived as a single wave. For instance, is human behavior, a factor of human being that constantly changes; hence, identifying an individual. Another is a pattern constantly changing in the body that may signify a disease, pain or illness. Finally is the critical element called pandimensionality, which is according to Rogers (1991), â€Å"a nonlinear domain without spatial or temporal attributes.† Focusing on this theory, many have remained inconclusive, undetermined, and still incomplete. Although it seems genuinely brilliant, the theory exists as impossible, yet, structuralizes the nursing concept in a depth. Moreover, factors remaining in sight of Science of Unitary of Human Beings somehow do not coincide with the nursing process, even in educational or health care service. Hence, the theory still serves alienation from the nursing profession. Even if it is significant, many find it difficult to understand and implement. References Biley, F. (1990). Theory: An overview of the Science of Unitary Human Beings. Retrieved on February 27, 2008 from UnitaryHealthCare.com. Hektor LM (1989). Martha E Rogers: A Life History. Nursing Science Quarterly 2; 2, 63-73. Rogers ME (1970). An introduction to the theoretical basis of nursing. F A Davis, Philadelphia. Martha E. Rogers: A Short Biography. (2008). Retrieved on February 27, 2008   

The Physics of the Violin essays

The Physics of the Violin essays Musical instruments are divided into four primary families, determined by the manner of their construction and the way in which they are played. These four groups are named Stringed Instruments, Keyboard Instruments, Wind Instruments, and Instruments of Percussion. The Stringed Instruments can once again be broken down into those in which the strings are plucked, for example the harp or guitar, and those in which the strings are played with a bow, such as the cello or the violin (Abele, p.1). The violin is the most important stringed instrument as it plays a chief role in orchestras and sets the fundamental design and confers its basic principles upon the lower stringed instruments, such as the viola, cello, and double bass. It is the essential and the unique design of the wood, the bridge, and the bow that provide the listener with an exclusive and distinctive sound only a violin can produce. Violinmakers have always paid particular attention to their woods selection and the characteristics of each individual piece of wood. Makers often use different kinds of wood in the different parts of the instrument. They look at important properties such as elastic modulus, acoustic velocity, and acoustic damping (Dunlop, p.37). The elastic modulus of wood is much stronger along the grain than across it, and also depends on how moist or dry the wood is along with the species of wood (Dunlop, p.38). Acoustic velocity, or the sound speed of a medium, has been measured in a wide range for different woods. Sound traveling along the grain and across the grain have produced dissimilar values with each other and among various woods. Studies show that sound passes through the wood medium at least four times faster along the grain than across the grain (Dunlop, p.38). Acoustic damping can be described as the time required for vibrations to decay. When high frequencies are played, s mall motions of atoms will generate heat and cause damping...