EHR Implementation and Effects on Nursing Essay -- medical records, he

EHR Implementation Background The implementation of electronic health records (EHR) continues to make an impact on nursing and patient care throughout the country. As a part of the American Recovery and Reinvestment Act of 2009, all public and private healthcare providers were required to implement electronic health records in their facilities by January 1, 2014. By demonstrating â€Å"meaningful use† of the electronic medical record, facilities are able to maintain Medicaid and Medicare reimbursement levels. Providers who show that they are meeting the â€Å"meaningful use† criteria during EHR use will receive an incentive payment from Medicare and Medicaid. â€Å"Meaningful use† is â€Å"using certified technology in EHR implementation to improve quality, safety, efficiency, and reduce health disparities; engage patients and families; improve care coordination; and maintain privacy and security of patient health information† (Centers for Medicare & Medicaid Services, 2013). The federal government has encouraged EHR use in hopes that it will significantly improve patient care. There is the intent that electronic health records will allow any provider access to important patient health information no matter where the patient is, while â€Å"creating a comprehensive national electronic health information network that leads to a reduction in the duplication of tests, an improvement in the cost-effectiveness of interventions, and the ability to compile a comprehensive patient history† (McBride, Delaney, Tietze, 2012). While the implementation of EHR’s has good intent, an important question is, â€Å"How are the implementation of EHRs having an effect on emergency nursing and patient care?† Benefits of EHR Use in the Emergency Department Nurses are... ...ers to consider long-term benefits. (2012). ED Management, 24(3). Guterl, G. (2012, April 2). Motivating Meaningful Use on ADVANCE for Nurses. Retrieved February 18, 2013, from http://nursing.advanceweb.com/Features/Articles/Motivating-Meaningful-Use.aspx Kutney-Lee, A. (2011). The effect of hospital electronic health record on. NCBI, 41(11). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236066/ McBride, S., Delaney, J., & Tietze, M. (2012). Health Information Technology and Nursing. American Journal of Nursing, 112(8). Retrieved from http://www.nursingcenter.com/lnc/pdf?AID=1402619&an=00152258-201301000-00010&Journal_ID=&Issue_ID= Meaningful Use - Centers for Medicare & Medicaid Services. (2013, December 6). Retrieved February 19, 2015, from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html

Jorge Borges Life Seen In The Secret Miracle Essay -- Jorge Luis Borg

In 1944, Jorge Luis Borges published â€Å"The Secret Miracle†, a short story describing Jaromir Hladik, a Jew living in the Second World War. Jaromir Hladik is taken away by the Germans to a jail by the Germans to be executed shortly after. While in jail, he ponders on all the ways he could be killed and later realizes that he still has yet to finish his play â€Å"The Enemies†. He prays to God, begging for a year to be granted to him so that he can complete his last masterpiece. In a dream, he is granted that year. When the Germans pull the trigger, the world freezes for a full year so he can finish his play. At a first glance, â€Å"The Secret Miracle† appears to be merely a fictioness story. However, Borges included so much of his own life in the character of Jaromir Hladik that the story no longer seems to be so made up. â€Å"Borges writing was impelled and shaped by experience† (Williamson 296). Borges grew up loving books from the very start of hi s life. His father was always a reader, so he had a room set up like a library that housed hundreds of books. Borges also grew up in a family with colorful war history, which allowed him to be introduced to interesting stories early on. At the age of 56, he was completely blind, causing him to see literature in a different way. He no longer thought literature was a reality. For instance, he believed that although an apple is called an â€Å"apple†, it may not actually have that name. Yet he continues to write in this unreality for he feels that it is a writer’s duty to speak out against Juan Peron through literature. In spite of Borges’ belief that literature is not reality, there is evidence of Borges’ life embedded in it which clearly shape the issues and concerns of his work. Borges was always one ... ...ss, which is difficult and requires strategy to succeed. This would fit in with Borges struggle to succeed in his work. In addition, Borges states that, â€Å"No one could any longer describe the forgotten prize, but it was rumored that it was enormous and perhaps infinite† (Borges 166). This could be referring to the prize of life. Many speak of life as being grand, yet no one actually knows whether life on Earth is a prize or not. It goes on to say that Hladik does â€Å"not remember the chessmen or the rules of chess† (Borges 166). In other words, Borges no longer remembers how to live his own life. Borges was first introduced to the game of chess by his father who â€Å"presented him with mathematical theories and philosophical puzzles† (Sickels 4) while teaching him how to become a better chess player. Perhaps this was Borges’ first encounter with the philosophy of life. Jorge Borges' Life Seen In The Secret Miracle Essay -- Jorge Luis Borg In 1944, Jorge Luis Borges published â€Å"The Secret Miracle†, a short story describing Jaromir Hladik, a Jew living in the Second World War. Jaromir Hladik is taken away by the Germans to a jail by the Germans to be executed shortly after. While in jail, he ponders on all the ways he could be killed and later realizes that he still has yet to finish his play â€Å"The Enemies†. He prays to God, begging for a year to be granted to him so that he can complete his last masterpiece. In a dream, he is granted that year. When the Germans pull the trigger, the world freezes for a full year so he can finish his play. At a first glance, â€Å"The Secret Miracle† appears to be merely a fictioness story. However, Borges included so much of his own life in the character of Jaromir Hladik that the story no longer seems to be so made up. â€Å"Borges writing was impelled and shaped by experience† (Williamson 296). Borges grew up loving books from the very start of hi s life. His father was always a reader, so he had a room set up like a library that housed hundreds of books. Borges also grew up in a family with colorful war history, which allowed him to be introduced to interesting stories early on. At the age of 56, he was completely blind, causing him to see literature in a different way. He no longer thought literature was a reality. For instance, he believed that although an apple is called an â€Å"apple†, it may not actually have that name. Yet he continues to write in this unreality for he feels that it is a writer’s duty to speak out against Juan Peron through literature. In spite of Borges’ belief that literature is not reality, there is evidence of Borges’ life embedded in it which clearly shape the issues and concerns of his work. Borges was always one ... ...ss, which is difficult and requires strategy to succeed. This would fit in with Borges struggle to succeed in his work. In addition, Borges states that, â€Å"No one could any longer describe the forgotten prize, but it was rumored that it was enormous and perhaps infinite† (Borges 166). This could be referring to the prize of life. Many speak of life as being grand, yet no one actually knows whether life on Earth is a prize or not. It goes on to say that Hladik does â€Å"not remember the chessmen or the rules of chess† (Borges 166). In other words, Borges no longer remembers how to live his own life. Borges was first introduced to the game of chess by his father who â€Å"presented him with mathematical theories and philosophical puzzles† (Sickels 4) while teaching him how to become a better chess player. Perhaps this was Borges’ first encounter with the philosophy of life.

Police Legitimacy Notes Essay

Effectiveness of the police ultimately depends on their legitimacy. – 1st b/c the moral paradox underlying the police use of nonnegotiable coercive force can be resolved only if police actions are qualitatively distinct from other actors’ use of force. – 2nd b/c people tend to obey authority out of respect for its legitimacy more than out of fear of its power. Greater police legitimacy decreases the need for nonnegotiable coercive intervention; it also builds active community support for police efforts. -â€Å"Perceptions of legitimacy carry more weight w/ the public than effectiveness of enforcement. †-Tyler, Tom; 88) – Tyler and Huo (2001): perceived legitimacy of the police and perceived fairness/favorability of outcomes carry equal weight in citizens’ acceptance of officers’ decisions. The amazing transformation of LAPD: 76% of Latinos and 68% of blacks now give LAPD positive grades (LA Times, 2009 poll) Weber- Tragedy of Power â⠂¬â€œ At some point, force is inevitably necessary to preserve peace and social order. GRAHAM v. CONNOR * The police use of force is a perennial reminder of the fundamental imperfection of the tragedy of power. * When all else fails, people call the cops (Egon Bittner) ; this is b/c the police role is ultimately define by their monopoly on the right to use nonnegotiable coercive force. We rely on the police precisely because of this monopoly; yet at the same time, we are repulsed by its underlying harsh reality. †¦Leads Us To Mary-Douglas â€Å"Purity and Danger† * We value dirty work as necessary but are repelled by those who do it so there is a moral ambiguity of force, which means that force is sometime necessary, but the decision to use it and judging the extent of its use are inherently unclear.

Environmental Problem: Buried Waste Disposal Sites

Buried waste disposal sites, especially those are near or the actual spots for residential houses, pose great threats to the health and wellbeing individuals who will be exposed more specifically to contaminated water systems. (â€Å"Background on Buried Waste at INL Site,† 2008) Aside from the contamination of the water system that might result to illnesses and diseases caused by water-borne bacteria and viruses, residential houses built on buried waste disposal sites might experience extreme termite or rodent problems which are unsanitary and harmful to the health of families who live in the area.Another issue is the impending threat of obtaining respiratory illnesses from air pollution caused by the excessive amount of chemicals and other compounds present in the area. (Krieger & Higgins, 2002) When it comes to the safety of living in an area built on a buried waste disposal site, there are little guarantees that the foundation of the houses is solid enough to last for the next decade. Chemical processes that take place due to the contact of chemicals underneath the soil might affect the quality of the land and its ability to be unyielding to deterioration and wreckage.(â€Å"Fact Sheet,† 2006) Learning that the house my family and I has been staying for in the past fifteen years was built over a buried waste disposal site would cause a sudden alarm. There is a need to report this issue to authorities, or institutions who are involved with the issue and will be able to help resolve the problems. Government agencies, real estate institutions, neighbors, and other private institutions that specialize in the area of environmental policies and implementation should be informed of such problem.Next, there is a need to recommend evacuation to safer areas for the meantime while studies will be conducted to determine the potential problems that have affected the topography of the area and the potential problems that might have long-term effects on indi viduals who have stayed in the area during the last decade. Also, undergoing medical examination and health-related assessments would be a great move to determine if the time spent living within the area has had an impact on our health and wellbeing.In terms of evaluating the land located over a buried waste disposal site, there are various techniques or approaches available to evaluate potential problems in the future. To determine the impact of the buried waste on the water system, there is a need to implement the processes of waste containment, area restrictions, and groundwater monitoring. Although water sampling would suffice in determining the level of contamination, if present, in the water system, there is a need to implement a thorough process of involving not only the groundwater but the buried wastes in the area.These processes will help authorities to determine whether the buried waste is affecting the water system, and if not, to establish ways to prevent it from happen ing. Moreover, this will also help in determining whether the people who have lived in the area have been exposed to dangerous bacteria or viruses from the contaminated water system. (â€Å"Fact Sheet,† 2006) Another method of approaching the buried waste disposal site problem is the implementation of the baseline risk assessment. This process helps environmental officers and professionals in determining the types of contaminants present in the area.Through the use of historical records and other information that pertain to how the waste disposal site was managed in the past, environment conscious institutions will be able to determine how to approach the problem. They will be able to determine what types of contaminants to look for based on the types of waste disposed in the area. (â€Å"Buried Waste Environmental Investigation,† 2006) Perhaps the most thorough process of evaluating the risks posed by the buried waste disposal site is the risk screening approach.This process follows the direction of the potential impacts that the waste might produce, from its source to its closing stages. The site will be screened in every aspect and dimensions, making sure that possible effect are identified. Once this is concluded, it is time to conduct prevention measures according to the level or priority – depending on the magnitude of damage or threat that the site may impose on the area and human life. (Environmental Protection Agency, 2007) References â€Å"Background on Buried Waste at INL Site. † (2008).Retrieved November 11, 2008, from Idaho Cleanup Project. Website: http://www. id. doe. gov/NEWS/PressReleases/PR080701-Announcement/HistoryofBuriedWaste. pdf â€Å"Buried Waste Environmental Investigation. † (2006). Retrieved November 11, 2008, from Idaho Cleanup Project. Website: https://idahocleanupproject. com/Portals/0/documents/BuriedWaste%20factsheet%20english%20FINAL. pdf Environmental Protection Agency. (2007). CODE OF PRACT ICE: Environmental Risk Assessment for Unregulated Waste Disposal Sites. Website: http://www. epa.ie/downloads/advice/waste/waste/epa_cop_waste_disposal_sites. pdf â€Å"Fact Sheet. † (2006). Retrieved November 11, 2008, from Environmental Protection Agency. Website: http://www. epa. gov/region7/factsheets/2006/fs_eeca_former_ne_plant_mead_ne1106. htm Krieger, J. & Higgins, D. L. (2002). Housing and Health: Time Again for Public Health Action. American Journal of Public Health, Volume 92, Issue 5. Retrieved November 11, 2008, from ProQuest. Website: http://proquest. umi. com/pqdweb? did=118106560&sid=2&Fmt=3&clientId=4538&RQT=309&VName=PQD

African American Reconstruction African American History

Once freed, African Americans believed that the rights of a citizen were granted to them. They truthfully believed this because after a brutally fought war, basic rights such as education, land, and employment were so modest, they were undeniable. Even though they were proclaimed as free, their place is society remained unaffected. The Freedmen's Bureau became one of the earlier agencies to provide support for newly freedmen. The agency offered education, advice and protection to its members. The most significant asset of the bureau was education. The literacy rate of African Americans rose about twenty percent due to the organization. Some freedmen even attended colleges to earn degrees. Many white Southerners viewed the African American attempt at education as a waste of time. They condemned the efforts of their social improvement. With much criticism by racist whites and inadequate funds, the Freedmen's Bureau concluded by 1872 injuring African American hopes of social equality. Another goal of African Americans was the ownership of land. To the freedmen, land ownership was equivalent to economic independency. However, they were mistaken. Economic independency was an unrealistic goal in the southern environment. As former slaves, African Americans were very familiar to the agricultural life style. As a result of Sherman's raids across the south, large plots of land were left uninhabited. Vast amounts of freedmen took the opportunity to occupy these lands. In 1866, Congress also passed the Southern Homestead Act giving African Americans access to public lands in five southern states. Contrary to what the freedmen believed, land ownership did not ensure financial success. Most land owned by African Americans was small and had an inferior value compared to white farms.

Technology with Business Essay Example | Topics and Well Written Essays - 1500 words

Technology with Business - Essay Example It is used to automate the payroll functions. As a result of this automation, Microcel has been able to reduce the level of paperwork to a substantial level. Another module is attendance which in combination with biometrics automatically tracks employee attendance records. These software modules are tested in-house and therefore the HR processes which are standardized are automated. This saves a considerable level of costs. The company operates in a highly competitive industry and the use of cost-saving technology enables it to develop a competitive advantage. Technology in sales and marketing Because the software development industry is characterized by high competition, Microcel must attempt to provide solutions which deliver a high level of value. By employing information technology, the company improves operational efficiency and therefore is able to provide great customer service. According to the sales manager, the implementation of information technology enables his sales forc e to stay in constant touch with the customers, thus creating an efficient communications system. Because the company is in the business of providing IT services, it has the infrastructure which can incorporate the latest IT technology. This also serves as a unique selling proposition. The clients can see the software technology function at Microcel and thus make their purchase decisions. Therefore the use of IT enables Microcel not only to improve the efficiency of operational processes within the company but also to demonstrate the products to the clients. In this manner the software products not only generate revenue but also save costs. As mentioned before, the company operates in a competitive industry. There are quite a number of other companies which are developing human resource software. Other companies such as Trinet and Administaff are also developing human resource software. Therefore Microcel has to develop the best products in the industry so that it can continue to wi n market share away from other competitors. Because competitors like Trinet and Administaff are already well entrenched in the market, it may not be possible for a smaller company like Microcel to compete with them. Therefore the strategic focus of the company has been to focus upon those segments of the market which have not been using software products up to this time. These smaller companies do not have the resources to make massive cash outlays for purchasing software products. For this reason Microcel has focused upon minimizing product development costs. This allows the company to offer products at a relatively lower cost, thus making them affordable to the smaller companies which have not considered installing human resource information systems. Technology in human resource management At Microcel , the employees are considered to be the most important assets. Therefore the management focuses upon maintaining a motivated work force. Since the company operates in a competitive environment, it has to create a sustainable competitive advantage. According to Porter’s framework for competitive strategies, a company can implement the strategies of cost minimization, differentiation and focus to create a competitive advantage. However the competing organizations can also implement these same strategies and therefore none of the companies has a competitive edge any longer. On the other hand, if the organizational culture serves as the source of the competitive edge, then it becomes sustainable

Images Essay Example | Topics and Well Written Essays - 1250 words

Images - Essay Example e image and clarity of the image have been presented very well as the viewer does not take much time to visualize on the content and the composition of the image. In fact, the artist in his painting techniques had designed the image to create a sense of humor to any viewer that could be viewing the image for his work or any study purposes o any other purpose. Most of the images made by using different kind of color as this artist has used are mostly appealing to the viewers as they are simple to understand and interpret. There is less time involving in visualizing their composition. Contents and the forms of such particular images also present a cool temperature nature of the conditions they were taken. 2. The image below is that of altostratus clouds. These clouds are usually characterized by dense, gray layer cloud that is often evenly and opaquely to enable any form of a little sunshine to penetrate. In this image, the background is very dim and thereby portraying that the atmospheric perspective point from where the photograph was captured. It could have been at the very far distance or from an aerial point of view. Observers can articulate from the image that that the art of calligraphy was of low representation as it its hue is much dim. The photo seems to be from an area that had very bright light hence interfering with the color strength of the background of the product. From the look of the image, observer can represent its temperature to be that of a cool scenario due to its dimness. The artist, therefore, could have used any of the complimentary colors; that is either red and yellow or yellow and blue or yellow and violates to give the image the strongest contrast it could have. People can also see the use of pointillism when viewed from a very close range since there are some small dots that could be seen at the background of the image. The small dots that the artist used during his painting work could also create an impression on the image as of