The Fall of Great Societies - 745 Words

Imagine a world where there were no problems, and everyone is happy. Few societies have not even been close to being this perfect. Great societies fail due to weak security systems, poverty, and inequality. The failed societies of Ancient Rome, Africa, and the dystopian novel Divergent by Veronica Roth, are all examples of great societies failing because of these three reasons. Weak security systems can be a huge impact on why societies have failed. In the book Divergent, the security system is available to hack into. This is not good to hack into computer systems because it can ruin all of the data of the society. Veronica Roth writes, â€Å" He presses the screen again, and everyone on the first floor goes still. There arms drop to the sides. And then the Dauntless move..... All the tension in my chest unravels, and I sit down, heaving a sigh... â€Å" I have to get the data,† he says, â€Å" or they’ll just start the simulation again.†.... â€Å" Got it,† says Tobias, holding up the computer’s hard drive† (Roth 480). This is not good for the society because if all of the data is able to hack into, the society is in danger. Invasions and attacks are popular ways that lead to societies failing. According to the video we watched, â€Å"Romans fought against themselves for control of the empire. They tried to defend it but it stretched as it was, the economy began to fail, but then came invasion. In the Western Empire, many citizens lost the will to fight. Then Rome’s security system came apart.Show MoreRelatedThe Main Causes Of The Fall Of Great Societies1328 Words   |  6 PagesGreat societies fail all around the world at anytime, is America in danger? How can we prevent our society from falling like others? Many past societies have fallen for various reasons, some reasons occur more than others and the three mains reasons that string through many of the societies are: political corruption, differing opinions in religion and excessive military spending. This information not only shows us information that caused powerful societies to fall but also shows what people rightRead MoreWhy Great Societies Fall Essay672 Words   |  3 PagesWhat is a great society? The key components to a great society are good economic values, strong government, and to make sure your citizens are happy. H owever, these societies have the opposite of that. These societies have bad laws and rules, citizens living in poverty, and they go through a ton of wars, but losing every single one. Leaving almost all of their soldiers dead. Minority of the societies getting treated unfairly, citizens rioting, dying, with no food, water, or even shelter for themRead MoreThe Role of Women in Society - Things Fall Apart Compared to Mother Was a Great Man704 Words   |  3 Pagesof Women in Society Things Fall Apart, by Chinua Achebe, demonstrates the original and traditional cultures of African, predominantly the Igbo culture. In traditional Igbo culture, men are perceived as the dominant and most powerful sex, while women are perceived as weak lesser people. Although women seem to play an inferior role in society, there are many traditions that exemplify the value and importance of women to males in society. Although women are mistreated, the Igbo society assigns importantRead MoreHow Societies Fall1272 Words   |  5 Pagesof a society without any flaws? A society where everything is perfect? Well keep dreaming because there is no such thing as a â€Å"Perfect Society† and there never will be. All societies fall, whether its from governmental corruption, Social injustice, or even economical failure. Calling something a perfect society is a difficult task, and Im not sure if anyone has ever been able to prove of their societies perfection. All societies will fail, the only difference is that not all will fall the sameRead MoreWhy Societies Fall644 Words   |  3 PagesWhile Great societies are well great, nothing can last forever. Many great societies that people thought will never die have fallen to various things. Take rome, they fell because inflation of money, which didnt allow for much spending. Or the Nazi’s. That Nazi government was very corrupt and fell because of what they did. Or even the Etruscans. They were overthrown by the very people they governed. So Societies fall for many reasons, including corrupt leaders, money inflation, and social rev olutionRead MoreThings Fall Apart By Chinua Achebe868 Words   |  4 PagesThings Fall Apart Author of The Perks of Being a Wallflower, Stephen Chbosky wrote, â€Å"Things change. And friends leave. Life doesn’t stop for anybody† (Change). Change is inevitable to people at least once in their lives. While change can be intimidating, change can be both positive and negative in different aspects. The title of â€Å"Things Fall Apart† suggests the change that is to occur through the story and that most things cannot last forever. Titles of any work of literature hold valuable significanceRead MoreThe Main Problems in Fallen Societies947 Words   |  4 PagesSocieties fall due to three main problems, corrupt government, unemployment, and lack of freedom for citizens. So many things have fallen from grace, including society, I say it as a whole and not a plural due to the general rule that every society falls at some point. In a few sentences, describe what your entire essay will be about. You should state the three reasons why great civilizations and socie ties fall. There are three main reasons, all stemming from that fact that humans destroy what theyRead MoreReasons Behind the Fall of Rome, Mohenjo Daro and the Fictional Society in Unwind695 Words   |  3 Pagesfictional society of Unwind, everything falls at some point. The falling of societies is common, every society ever has fallen and has yet to fall. Societies fall due to corrupt government, overuse of resources and citizen revolts. Rome, Mohenjo Daro and Unwind fell due to those reasons. Societies can fall for a number of reasons, such as corrupt leaders or a corrupt government in general. Of all things corrupt government in general is pretty common, just think of Rome, or the fake society of UnwindRead MoreThe Fall of Rome and Nazi Germany697 Words   |  3 PagesSocieties flourish and fall, all of them do. They fight and suffer and even kill to keep their society alive. As a result, societies like ancient Rome and Nazi Germany, eventually fall and crumble. Over time some of these societies recover, but are never the same again. Societies fail due to political corruption, loss of resources and war. These obstacles are hard to overcome, but not impossible. These obstacles weaken and tear at societies, until they finally break, turning them into a piece ofRead MoreFallen Societies Undergo Social Injustice, Government Corruption, and Poverty 1218 Words   |  5 Pagessocial judgements? In different societies there are many different reasons that they could fall. S ocial injustice, corrupt government, and poverty are some of the different reasons that will be written about. In Divergent, Rome and Nazi,Germany there were similar downfalls between all of the societies. There are many ways for different societies to fall; social injustice, corrupt government, and poverty. Although there are many different reasons that a society could fall due to different political reasons

The World War I And The Death Of The Adolf Hitler

Born in Austria in 1889, he rose to power in German politics as leader of the National Socialist German Workers Party, also known as the Nazi Party. He was chancellor of Germany from 1933 to 1945, and served as dictator from 1934 to 1945. His policies triggered World War II and oversaw fascist policies that resulted in millions of deaths. Today we will discuss the early years, artistic dream, the role in World War I, rise to power, the leadership of Der Fà ¼hrer, and the death of the infamous Adolf Hitler. Adolf Hitler was born on April 20, 1889 in the Austrian border town of Braunau am Inn. His birth place is located roughly 65 miles east of Munich, Germany and 30 miles north of Salzburg, Austria. He was the fourth of six children born†¦show more content†¦At the age of fifteen, Hitler dropped out of primary school to follow his dreams of becoming an artist, and, at the age of 18, he moved to Vienna with money inherited after his father s death in 1903, in order to pursue a career in art, as this was his best subject at school. Werckmeister states that he went there intending to see operas and study the famous picture gallery in the Court Museum. Instead, he found himself fascinated by the city s beautiful architecture. Hitler put all his hope in the dream of achieving greatness as an artist. He wished to attend the Vienna Academy of Fine Arts. In October 1907, he took the two day entrance exam for the academy s school of painting, but his test drawings were judged unsa tisfactory. He was not admitted. He was encouraged to consider the field of architecture. But without the required high school diploma, he would not be accepted into architecture school either. Thus, Hitler’s dreams of becoming a professional artist came to a bitter end (Werckmeister.) According to Klaus, Hitler moved to Munich, Germany in May 1913 in order to avoid arrest for evasion of his military service obligation to Habsburg Austria. It was financed by the last installment of his inheritance from his father. In Munich, he continued to drift, supporting himself on his watercolors and sketches until World War I gave his life new meaning. Klaus stated that Hitler was a brave soldier. He was promoted to the rank of Corporal, was

Lack of Sleep for Patients

Question: Give the literature review to identify problem area and justify the project to demonstrate a link to the evidence? Answer: Introduction The hospital environment is not the one that is conductive to sleep. The patients whoo are in the ICU are susceptible to disruption of sleep, which is secondary to environmental and medical issues. Although the frequency of such cases where the sleep of the patients is disrupted, is high, the quality of care being delivered to the critically ill patients is generally overlooked (Salas, R. and Gamaldo, C., 2008). The literature survey shows that the hospital wards have been associated with the difficulties experienced by the patients in falling asleep and getting insufficient sleep. And this eventually results in the sleep disturbances. These problems are restricted to the patients who are admitted into the ICU or are in the acute care settings. But very little research has been done on the conditions experienced by the older people who are admitted to the hospital and the problems or difficulties experienced by them with respect to their sleeping pattern (Ancoli-Israel S., 2009). In an exploratory qualitative research carried out on the older people, it was found that all the participants (older people) were subjected to dynamic changes in their sleeping pattern during the period of their hospitalization and this led to deprivation of sleep and even its disruption. The research concluded that the public environment of the ward and the prominent sense of helplessness was the main reason that caused lack of sleep. Moreover, the older people also reported the prevalence of certain cultural and social beliefs that hindered the opportunities of getting adequate amount of sleep. The research in this field is very essential as the implication of the nursing practice of inclusion of the assessment of the sleep in the patients during their admission in the wards, is important. Older patients perceive this assessment task as a vital component of the usual routine of the ward and should be used wherever possible (Lee, C et al., 2007). The lack of adequate sleep has been a ssociated with the dysfunction of the immune system, accompanied by the impairment of the resistance to any kind of infection as well as the alterations in the nitrogen balance and delaying in the healing of the wound. Although the effect of the surgical admission of the patients into the ICU and the impact on their sleeping pattern and the architecture, remain undefined, many research studies (both qualitative and quantitative) have been conducted to study and describe the quality and quantity of sleep as well as the architecture, as defined by the polysomnography (Randall et al., 2007). Therefore, it is important to devise methods for helping the patients to achieve maximum sleep and follow a designed pattern so that the immune system and the other functions of the body are not disrupted. This research proposal aims to improve the care experience of the patients by allowing them to sleep without any disruption, thereby helping in improving their patient related outcome and increas ing their satisfaction level. The project also aims to devise such methods that maintain the privacy and the dignity of the patients ane enable them to have their own say in the decisions regarding their care. Literature Review Lack of sleep is a critical issue for patients in basic consideration units. Slumber is an intricate, dynamic process that is isolated into 4 phases of non-fast eye development (NREM) slumber, and quick eye development (REM) rest. Clamor, lights, inconvenience, torment, prescriptions, and stretch all add to a persistent's failure to rest. Absence of information about the slumber stages, nursing schedules, and continuous nursing evaluation and mediations likewise affect the discriminatingly sick quiet's capacity to rest. Instruction about lack of sleep needs to be coordinated into discriminating consideration courses and introduction programs. Lack of sleep ought to be tended to on the multidisciplinary consideration arrangement and in wellbeing group meeting, and nursing consideration arranged appropriately. Rest solutions and their belongings ought to be assessed for every patient, and in addition distinguishing medicines that may be anticipating or aggravating slumber (Lee-Chiong T ., 2008; Cronin AJ, Keifer JC, Davies MF, King TS, Bixler EO., 2001). Proof recommends that intense disease/damage and the ICU environment decrease remedial slumber, in any case, it has been hard to evaluate event rates because of differed meanings of slumber aggravation, estimation issues, and the difficulties of directing slumber examines in the ICU (Redeker NS, 2008). Despite the difficulties, confirmation proposes that a generous extent of ICU patients experience poor slumber quality, delayed slumber inactivity, and incessant arousals/enlightenments that add to physical and passionate distress (Cooper et al., 2000; Gabor JY, Cooper AB, Hanly PJ, 2001). In a vast investigation of therapeutic and surgical ICU patients (n = 1,625), 38% accomplished trouble nodding off, and 61% reported a more prominent than normal requirement for sleep (Orwelius et al., 2008). In another study, almost 70% of ICU patients with growth encountered a moderate or serious level of slumber unsettling influence, and poor slumber was distinguished as a standout amongst the mos t distressing parts of their ICU stay (Nelson et al., 2001). Several months after healing center release, more than a large portion of ICU survivors (n =39) kept on encountering more terrible intruded on slumber or modified slumber examples contrasted and their prehospital patterns (Kelly MA, McKinley S., 2010). Sleep examine in the ICU is in its outset and further examinations of medical attendant driven appraisal and mediations are expected to minimize the negative results of slumber unsettling influence in basically sick patients (Friese RS, 2008). Most of the patients who are admitted in the critical care unit of the hospital, experience disturbance in their sleep, which increases or adds on to their illness. Even psychological stress alone can have a huge but negative impact on the sleeping pattern of any individual. Research based statistics say that critical care patients spend around 40-50% of their time being awake and out of the remaining time only 3-4% is spent in REM sleep. During the stay in the hospitals, the patients suffer from excessive psychological stress. These stressors lead to the need for more REM sleep for the patients but the psychological state of mind prevents them from getting adequate amount of sleep (Honkus, V., 2003).In a study carried out by Novaes and colleagues, the evaluation of the physical and psychological stressors that are responsible for sleep deprivation in the Intensive care unit (ICU). The study was conducted with 50 patients and they were asked to fill and submit the Intensive Care Unit Environmental Stressor Scale, in which there were 40 items that were to be ranked from being very stressful to not stressful. Amongst these items, the inability to sleep, was ranked at the second most stressful condition, first being the pain (Novaes et al., 1997; Lautenbacher S, Kundermann B, Krieg JC., 2006). Lack of sleep has been indicated to impel a catabolic state and adversely influence the resistant framework and recuperating (Goel N, Rao H, Durmer JS, Dinges DF, 2009). There is diminished capacity to oppose and battle contamination, further affecting the mending process and hospitalization. Notwithstanding immunosuppression and diminished tissue repair, studies report diminished agony resilience and significant weariness of the thoughtful operational hubs. Ordinarily, cortisol is discharged in the morning to help set up the body for the day's stressors. Cortisol is additionally discharged amid time of anxiety, and serves to diminish aggravation by bringing about adjustment of lysosomal layers in harmed cells. Drawn out emission of cortisol in any case, meddles with the body's capacity to mend and battle disease on the grounds that it can hinder the aggravation methodology, restrain development of connective tissue and granulation, and smother counter acting agent formation. Cortiso l discharges are regularly lessened amid slumber and ascend during the early hours after circadian rhythms. Lack of sleep in discriminating consideration patients draws out cortisol discharge and results in diminished mending, making patients more vulnerable to disease and a delayed recuperation process. Lack of slumber has additionally been indicated to add to upper aviation route musculature brokenness and blunting of hypercapneic and hypoxic ventilatory responsiveness, antagonistically influencing gas trade. This could have a noteworthy effect on the patients who face problem with respiration, especially the individuals who are being weaned from the ventilator or the individuals who have recently been extubated (Honkus, V., 2003). Although the nurses are very attentive with respect to the signs and symptoms shown by their patients, the indication of lack of sleep are generally not very apparent during the initial stages). The behavioural changes like the irritation or restlessness may be seen within 48 hours. Even disorientation and slurred speech can be used as an evidence preceding psychotic behavior (occurring within 96 hours). Patients in the critical care unit spend most of their time in the lighter stages of sleep and therefore are not able to utilize the beneficial stages of sleep. The main reasons for this kind of sleep interference include noisy and unfamiliar environment, excessive lighting, pain, discomfort, stress, anxiety and the illness (Honkus, V., 2003). Natural commotion is because of a mixture of reasons, including ringing telephones, talking, beepers, speakers installed overhead, and hardware sounds from suction mechanical assembly and mechanical ventilation. Cautions from cardiovascular screens, beat oximeters, and ventilators add to the commotion contamination (Costa, S and Ceolin, M., 2013; Celik S, Ostekin D, Akyolcu N, Issever H., 2005). Especially irritating are ventilator cautions that are very loud while patients are being suctioned. Patients spotted close to the medical caretakers' station and storage spaces are regularly exposed to more commotion and light. General inconvenience is another reason generally given for failure to rest (Ohayon MM., 2009). Patients frequently whine about the healing center beds that are uncomfortable, and the failure to get settled. Being connected to observing hardware, for instance, keeps a patient from mulling over his stomach, if that is his favored resting position (Weinhouse, G and Scha wb, R., 2006; Bourne RS, Mills GH., 2004). The terminal pads used for seeing eventually cause the skin to wind up exasperated and irksome. Oxygen can cause extreme dryness in the nasal passage if it is supplied without being humidified. Having intravenous central lines, and dressings can lead to more discomfort. The temperature of the room or not sufficiently having spreads may unfavorably impact rest. In the midst of REM rest, thermoregulation is missing and shuddering or sweating can't happen, in this manner individuals' body temperature is clearly impacted by their surroundings. Right when the earth is unreasonably frigid or excessively hot, REM sleep will be lessened. Torment has been joined with the inability to rest in a couple of studies. In Novaes' study to evaluate physical and mental stressors in the ICU, 50 patients were given the Critical Care Unit Environmental Stressor Scale and asked to rank the 40 things from not disagreeable to uncommonly troubling. The patients pla ced isolation as the topmost thing that irritated them or the one which they found troubling, on the scale by these crisis unit Patients in essential thought units may have torment for a grouping of restorative and surgical reasons, and these patients are consistently subjected to therapeutic techniques that are anguishing too. It has been recommended that separating thought restorative guardians expect that the patients are highly stressed or at high peril for torment, and assess and treat in like way (Honkus, V., 2003). In one of the descriptive study aimed at identifying the pattern of sleep, its quality and quantity and also the prevalence, the scientists found that the frequency of sleeping problems with the patients admitted in the hospitals, was high. The data from the nurses was collected by means of conducting a questionnaire and the night reports of the nurses was evaluated. The disruption in sleep was in the form of delayed onset of the sleep or the early awakening, both of which resulted in short durations of total sleeping time. By the seventh day of admission the results related to sleeping disturbances improved significantly but still the patients complained about the feeling of restfulness in the early hours of morning. Yet again in this study, the identified causes of sleeping problem were the environmental factors like noise, light, cold, heat, disturbance by insects/mosquitos, etc. Even frequent awakening by the nurses for getting the hourly observations resulted in sleep deprivatio n. The study further highlighted the need for further re assessment of the habit of interrupting the sleep of the patients for certain procedures and the treatements (John, M, Edit, O and Mgbekem, M., 2007; Jacobi J, Fraser GL, Coursin DB, et al., 2002). The disturbance in the sleep wake cycle of the patients can prove fatal for their recovery. It is important to implement measures that take care of the patients during their admission in the hospital and help them take total hours of sleep in a comfortable and quiet manner (Lane, T and East, L., 2008). This protocol for initiating and promoting proper sleeping patterns begins with the initial assessment of the patient and the family for identifying the actual sleeping patterns of the patient. The patient should be questioned about the factors or the conditions that help him/ her sleep well at home. Secondary to this, the patient should be analysed for the the persisitent pain, anxiety or dyspnea and the conditions that help the patient in overcoming these conditions of health/ illness Drouot X, Cabello B, d'Ortho MP, Brochard L., 2008; Berger AM., 2009). This initial assessment is followed by the implementation of the sleep enhancing interventions like assisting the patient in comple ting the night time routine that is familiar to him/ her, helping him/ her to find a comfortable sleeping position (Sethi, D., n.d). The main help that a nurse can do is to reduce the environmental stress or restlessness by dimming the lights, maintaining a quiet and peaceful environment, closing the doors, keeping all the phones on silent (near to the rooms of the patients) and refraining from using the intercom (except in very urgent or emergency situations). Literature has proved that by promoting the long blocks of uninterrupted sleep (by reducing the frequency of disturbing the patients) has yielded more fruitful patient outcomes. A warm drink before bedtime also helps in stimulating sleep (Colten HR, Altevogt BM, 2006). Studies have also shown that sleep deprivation is not only the cause of concern fro the patients but also for the parents who stay back at the hospitals. Due to stressors like the illness or the monotonous environment of the hospital, the sleep of the family members as well as the parents also tends to get disturbed, leading to adverse health outcomes (McCann, D, 2008). There have been many nursing strategies to promote proper sleeping patterns of the patients. There has been a great controversy regarding the impact of mechanical ventilation on the sleeping pattern and according to Orwelius, Nordlund, Nordlund, Edll-Gustafsson Sjberg (2008), mechanical ventilation has no significant impact on the sleeping pattern (Bosma et al., 2007). However, this hypothesis was contradicted by ugras and Oztekin (2007) because of ventilator dysynchrony. Similarly, the effect of routinely nursing cares like eye-mouth care, dressing, pressure area care, washing the patient, etc. further increase the disturbance of sleep. In 1993, Edwards and Schuring proposed a model according to which the care should be provided between 0100 hrs and 0500 hrs. There were many limitations to this model as well. But most of the hospitals are implementing the modifications in the working shifts in order to prevent sleep disturbance. Use of sedative medicines is also being encouraged as it promotes comfort, amnesia and sleep (Parthasarathy Tobin, 2006; Mistraletti, Donatelli Carli, 2005). Conclution The sleep disturbance and the corresponding fatigue are significant problems that affect mostly all the patients who are admitted into the hospital. There are many factors contributing to this condition of sleep deprivation- environmental, stress, medical or surgical conditions, medications, treatment, pain, etc. A combined approach is needed in order to allow the patients to sleep properly and relax in the comfortable environment of th ehospital. This project aims in providing the necessary interventions and the strategies that will promote appropriate sleeping patterns in all the patients. Taking after an extensive appraisal of ecological and patient components, a consideration arrangement can be contrived to give times of continuous slumber, recognize prescriptions regimens that advance rest and lessen exhaustion, and propose non-pharmacological mediations in view of individual patient needs and yearnings. Support from all individuals from the health awareness group is expected to actualize changes and make strides in tending to patients' slumber and vitality needs. Ideal administration of patients' slumber unsettling influence and exhaustion in the ICU may augment patient advance and enhance wellbeing results long after release from the intense consideration setting (Shields et al., 2004). Medical attendants are decently situated to distinguish issues in their own units that avoid compelling patient slumber. Instruction about slumber aggravation and weakness evaluation/administration needs to be coordinated into discriminating consideration courses and introduction programs (Honkus, V., 2003). References 1. Ancoli-Israel S. (2009). Sleep and its disorders in aging populations. Sleep Med., 10 Suppl 1:S7S11.2. Berger AM. (2009) Update on the state of the science: Sleep-wake disturbances in adult patients with cancer. Oncol Nurs Forum. 36(4):E165E177.3. Bosma, K., Ferreyra, G., Ambrogio, C., Pasero, D., Mirabella, L., Braghiroli, A., et al. (2007). Patient-ventilator interaction and sleep in mechanically ventilated patients: pressure support versus proportional assist ventilation. Critical Care Medicine. 35(4), 1048-1054.4. Bourne RS, Mills GH. (2004). Sleep disruption in critically ill patients--pharmacological considerations. Anaesthesia. 59(4):374384.5. Bryant, R., Creamer, M. Donnell, M, Silove, D and McFarlane, A. (2010). Sleep disturbance immediately prior to trauma predicts subsequent psychiatric disorder. Sleep, 33(1): 69-74.6. Celik S, Ostekin D, Akyolcu N, Issever H. (2005). Sleep disturbance: the patient care activities applied at the night shift . J Clin Nurs, 14(1):102-6.7. Colten HR, Altevogt BM, (2006). Functional and Economic Impact of Sleep Loss and Sleep-Related Disorders. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. National academic press.8. Cooper AB, Thornley KS, Young GB, Slutsky AS, Stewart TE, Hanly PJ (2000). Sleep in critically ill patients requiring mechanical ventilation. Chest., 117(3):809-18.9. Costa, S and Ceolin, M. (2013). Factors that affect inpatients quality of sleep*. Rev Esc Enferm USP, 47(1): 46-52.10. Cronin AJ, Keifer JC, Davies MF, King TS, Bixler EO. (2001). Postoperative sleep disturbance: influences of opioids and pain in humans. Sleep, 24(1):3944.11. Drouot X, Cabello B, d'Ortho MP, Brochard L. (2008). Sleep in the intensive care unit. Sleep Med Rev. 12(5):391403.12. Friese RS (2008). Good night, sleep tight: the time is ripe for critical care providers to wake up and focus on sleep. Crit Care, 12(3):146.13. Gabor JY, Cooper AB, Hanly PJ (2001). Sleep disruption in the intensive care unit. Cu rr Opin Crit Care., 7(1):21-7.14. Goel N, Rao H, Durmer JS, Dinges DF. (2009). Neurocognitive consequences of sleep deprivation. Semin Neurol, 29(4):320339.15. Jacobi J, Fraser GL, Coursin DB, et al. (2002). Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med, 30:119-41.16. John, M, Edit, O and Mgbekem, M. (2007). Sleep disturbance among patients in hospitals: implications for nursing care. West African Journal of nursing, 18(1): 42-48.17. Honkus, V. (2003). Sleep deprivation in critical care units. Critical care nursing quarterly, 26(3): 179-191.18. Kelly MA, McKinley S (2010). Patients' recovery after critical illness at early follow-up. J Clin Nurs., 19(5-6):691-700.19. Lane, T and East, L. (2008). Aleep disruption experienced by surgical patients in acute hospital. British Journal of nursing, 17(12): 766-71.20. Lautenbacher S, Kundermann B, Krieg JC. (2006). Sleep deprivation and pain perception. Sleep Med Rev , 10(5):357369.21. Lee, C et al. (2007). Older mens experiences of sleep in the hospital. Journal of clinical nursing, 16(2):336-343.22. Lee-Chiong T. (2008). Sleep Medicine: Essentials and Review. New York: Oxford University Press; 2008.23. McCann, D. (2008). Sleep Deprivation Is an Additional Stress for Parents Staying in Hospital. Journal for specialists in pediatric nursing, 13(2): 111-122.24. Mistraletti, G., Donatelli, F. Carli, F. (2005). Metabolic and endocrine effects of sedative agents. Current Opinion in Critical Care, 11(4), 312-317.25. Nelson JE, Meier DE, Oei EJ, Nierman DM, Senzel RS, Manfredi PL, Davis SM, Morrison RS (2001). Self-reported symptom experience of critically ill cancer patients receiving intensive care. Crit Care Med., 29(2):277-82.26. Ohayon MM. (2009). Pain sensitivity, depression, and sleep deprivation: links with serotoninergic dysfunction. J Psychiatr Res. 43(16):12431245.27. Orwelius, L., Nordlund, A., Nordlund, P., Edll-Gustafsson, U. Sjberg, F .(2008). Prevalence of sleep disturbances and long-term reduced health-related quality of life after critical care: a prospective multicenter cohort study. The Critical Care Forum, 12(4), 1-11.28. Parthasarathy, S. Tobin, M. (2006). Sleep in the Intensive Care Unit. In M. Pinsky, L. Brochard J. Mancebo (Eds.). Applied Physiology In the Intensive Care Medicine. (147-156). New York, Unites States of America: Springer.29. Randall, F, Ramon, D, Heidi, F and Larry, g. (2007). Quantity and Quality of Sleep in the Surgical Intensive Care Unit: Are Our Patients Sleeping? Journal of Trauma Injury Infection Critical care, 63(6): 1210-1214.30. Redeker NS (2008). Challenges and opportunities associated with studying sleep in critically ill adults. AACN Adv Crit Care, 19(2):178-85.31. Salas, R. and Gamaldo, C. (2008). Adverse effects of sleep deprivation in the ICU. Elsevier, 24(3): 461-476.32. Sethi, D. (n.d). Paediatric Sedation, Retrieved April 5, 2015, from https://www.anaesthesiauk.com/D ocuments/105%20Paediatric%20sedation.pdf#xml=https://www.frca.co.uk/SearchRender.aspx?pdf=onDocId=1008Index=D%3a%5cdtSearch%5cUserData%5cAUKHitCount=1hits=7e6+33. Shields et al. (2004). Sleep deprivation for pediatric sedated procedures: Not worth the effort. Pediatrics, 113(5): 1204-8.34. Ugras, G. Oztekin, S. (2007). Patient perception of environmental and nursing factors contributing to sleep disturbances in a neurosurgical intensive care unit. Tohoku Journal of Experimental Medicine, 212(3), 299-308.35. Weinhouse, G and Schawb, R. (2006). Sleep in the critically ill patient. SLEEP, 29(5):707-716.

Information Management Systems in the US medi

Executive Summary Organisations having much information to analyse as the basis of making decisions often employ large numbers of employees in case they do not deploy management information system (MIS) to ease the analysis process.Advertising We will write a custom assessment sample on Information Management Systems in the US medi-corp specifically for you for only $16.05 $11/page Learn More However, from the perspective of the US medi-corp, which is a hypothetical company, such an approach introduces ineffectiveness and inefficiencies in decision making especially where decisions from different departments are to be fed into a central platform to arrive at an overall decision to execute a given task. The current paper introduces ERP (Enterprise Resource Planning) as an MIS strategy for handling customer relationship challenges, supply chain management, and manufacturing function challenges of the US medi-corp. Background When an organisation grows in t erms of its size and production capacity, its customer and supply chain problems and complaints become difficult and time consuming to solve. This case is evident in the US medi-corp (a hypothetical company). The US medi-corp manufactures medical equipment, which it sales within the US after sourcing manufacturing materials from a myriad of suppliers located across the US. Apart from sales of products, the company also gets revenue from customer support services such as maintenance of the medical equipment. The company has a hierarchical management structure so that command flows from the top to bottom. Making the organisational decisions is informed by the information flowing from customers, suppliers, and other organisational stakeholders to and from the organisation. The strategic plan of the company is to exploit the global market. To achieve this goal, the US medi-corp values employees as the most important asset available to realise its strategic plans.Advertising Looking for assessment on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Operating in such a business environment, the company has been constantly looking for solutions to facilitate both urgent and quick decision-making processes especially in its effort to engage in the global trade. Setting the Stage The operation of the company has faced a number of problems in the continued effort of the US medi-corp to resolve supply chain and customer problems and complaints with urgency. Indeed, this major problem may hinder the success efforts of the company since, â€Å"in a fiercely competitive environment, business strategy not only determines success, but also governs business survival† (Fui-Hoon Lee-Shang 2001, p.285). Hence, it is important for the US medi-corp to anticipate putting in place mechanisms of response besides ensuring an ardent reaction to market place demands. Due to the increasing number of the customers that th e US medi-corp has to attend, problems such as quick location of the customer and determination of frequency of purchases for each customer have been encountered in the recent past. Consequently, making decisions on market targeting has proved problematic thus making the company suffer from being unable to precisely forecast its production. The above problem is even more significant by noting that making target marketing decision in good time results in challenges for â€Å"helping to determine, which of the business practices could be altered to increase customer numbers† (Grant, Hall, Wailes, Wright 2006, p.7).Advertising We will write a custom assessment sample on Information Management Systems in the US medi-corp specifically for you for only $16.05 $11/page Learn More Using the current information management systems, which are highly dependent on interaction of human decision makers (department heads and general managers) with segregated in formation systems running on different computers, location of past records involving customer communication is hard to access thus resulting to slowed resolution of customer disputes. In effecting the transactions between suppliers and organisation, the fact that information is held on different computers makes it difficult to urgently prepare all documents relating to a specific transaction (Kraemmerand 2003, p.229). This challenge forms a major hindrance to the attainment of the strategic plan of the company since â€Å"every minute that staff members spend on editing or otherwise generating paper work is an extra minute they are being less productive† (Head 2005, p.65). Therefore, a solution is necessary to enhance speedy preparing of documents ranging from invoices, shipping labels, purchase orders, receipts, and customer communication to preparation of manufacturing plans based on customers’ demands. Case Description People Perspective The challenges discussed abo ve among others have attracted various concerns from organisational stakeholders. The people of the US medi-corp are organisational stakeholders who are affected by the current state of information management systems. There is a challenge of efficient and effective management of the immense customer information base. Therefore, it has come to the attention of the US medi-corp that customers are conceiving the company as overlooking their orders. Consequently, the US medi-corp is concerned that it may lose dissatisfied customers to its competitors in the industry.Advertising Looking for assessment on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More In the attempt to build goods customer relations to retain them amid the looming challenges at least in the short-run before a solution is sought, the customer communication department sends individualised massages to explain the circumstances for order delivery delays coupled with other issues related with customer service. However, in this process, due to the large number of customer base, messages are sometimes sent to unintended customers. In some situations, messages are sent to the right customers though with the wrong preferred option. In the case of suppliers, staff members are incapable to make purchases of raw materials from the most outstanding suppliers. Organisational Perspective It is concerning the organisation that customer complaints and challenges in keeping track of the best suppliers will impair the success of the US medi-corp. With the increasing of customer base, the capacity of employees to handle the entire customer base both effectively and effectively with the current state of information management system is a major problem. In the realisation of this problem, the boards of directors coupled with the respective line managers meet to discuss the way forward. It was held that an intervention was necessary in the effort to ensure that the company will be able to handle even more quality and time cautious customers across the globe. In the organisation perspective, the most preferred strategy is the one that would result to low costs in the long run but ensure that customers are well satisfied with both by the products and services offered by the US medi-corp. Technology Perspective Current information management technology deployed at the company is customised for each department. For example, the manufacturing department makes decisions based on inventory levels of raw material, material in the process, and the finished products. Since the US medi-corp does not intend to hold large numbers of finished products, information from the sal es department is essential in determining manufacturing decisions. Unfortunately, since the information technology systems are customised as per the department, the manufacturing department depends on the analysed customer information from the sales department before consulting with the procurement so that raw materials can be sourced. This decision-making process takes time thus resulting to delayed order executions. In the effort to raise sale levels of the US medi-corp, the company has developed a web based sales strategy. However, this strategy faces a challenge since â€Å"web customers cannot choose a product related to the one they are looking for if they do not know that it exists† (Vilpola, 2008, p.63). From the technological perspective, a MIS technology that would integrate all the functions of the US medi-corp departments is required. Solution Design Options To help in the resolution of the problems faced by the US medi-corp, integration of the information managem ent systems is required to enhance rapid decision-making. Indeed, rapid decision-making is required for an organisation having large numbers of stakeholders whose contribution in the organisation affects the activities of the whole organisation (Dehning Stratopoulos 2003, p.211). For the case of the US medi-corp, this outcome could be attained in three main ways. The first option is to design a decision support system. The second option is to design and implement a transaction processing system. Finally, the third option is designing and implementation of a MIS that integrates these two systems. The choice of either system is based on SWOT analysis of each of the MIS systems. The decision support system has the strength of helping to make various decisions based on the analysis of data and statistical projections. Transaction processing system has the strength of â€Å"providing away of collecting processes, store, display, modify, or cancel transaction† (Mureell 2001, p.9). The decision support systems create an opportunity for improvement of the quality of the decisions made by organisation managers as opposed to replacement of the managers. Through a transaction processing system, an organisation gains an opportunity to permit multiple transactions to occur simultaneously (Davenport 2003, p. 128). In addition, through the transaction processing system, data collected by the system can be â€Å"stored in databases, which can then be used to produce reports such as billing, wages, inventory, summaries, manufacturing schedules, or check registers† (Fryling 2010, p.327). The two systems share common threats in that security of the systems is a big issue. A major weakness of the transaction processing system is that the appropriateness of the transactions is overly dependent on the accurateness of the information maintained in the databases. On the other hand, the decision support system is slower in helping to arrive at a decision because it inte racts with human decision makers. Upon consideration of the systems’ strengths and opportunities, the US medi-corp needs to take advantage of the strengths and opportunities of both designs. Hence, an integrated information system is selected for design and implementation. This system is the ERP (Enterprise Resource Planning). Solution and Implementation The selected solution is implemented so that the US medi-corp is able to integrate all its production and management function in a manner that decisions are quick to make and respond to all the US medi-corp stakeholders’ concerns in real time. Figure 1 below shows a schematic diagram of the modelling the ERP version to be used at the US medi-corp. Fig 1: Source (Turban et al. 2008, p.300) Implementation Methodology The implementation of the solution entangles the construction of the ERP system and introducing it in the US medi-corp. This step encompasses the construction of both software and hardware. Alternatively, t he hardware and the software can be sourced from manufactures who can customise it to suit the requirements of the US medi-corp. This option is preferred to save time that is required for the new MIS to be fully operational in the organisation. In the process of sourcing the software, bidding is the first step. The selected bidder will be based on the ‘low-price-bidder’ basis. However, the ERP software supplied must be able to support integration of external and internal management information throughout the US medi-corp. It should have modules for management of manufacturing functions, service and sales, modules for management of customer relationships, inventory control, production planning and forecasting, and procurement among other modules that would â€Å"facilitate the flow of information between all business functions inside the boundaries of the organisation to manage the connections to outside stakeholders† (Yusuf, Gunasekaran Abthorpe 2004). ERP is an expensive MIS in the short-run. Hence, the US medi-corp needs to cut the costs of hardware meaning that the ERP supplied needs to be compatible with the current US medi-corp’s hardware, which supports Windows NT, UNIX, and mainframe. Implementation of the ERP at the US medi-corp will require change management, which entails alteration of the processes that employees utilise to conduct the business of the organisation. Many operations that were executed by employees manually or with interventions of computers will now be integrated and automated throughout in the organisation’s processes. Therefore, employees will be retrained on how to use the new system to help them â€Å"share common data and practices across the entire enterprise to produce and access information in a real-time environment† (Fui-Hoon Lee-Shang 2001, p.285). Since the company does not have a technical team to facilitate the implementation of the MIS, a third vendor will be hired to evaluate the customisation needs of the organisation to suit its needs. Figure 2 below shows these customisation requirements. Fig 2: Customisation requirements The above areas of customisation evidences that ERP scope entangles significant alterations of staff work practices and working process (Monk Wagner 2009, p.56). Consequently, incomplete understanding of various processes before the implementation is initiated may lead to failure of the project (Somers et al. 2000, p.1001). The implementation methodology is based on the Markus and Tanis (2000) ERP life cycle. The phases are â€Å"chartering, project, and Shakedown† (Markus and Tanis 2000, p.173). The chartering phase comprises the evaluation of various decisions that lead to the funding of the ERP project. The main players in this phase are vendors, executives of the organisations, consultants, and the IT specialists of the company. The main activities encompass initiation of the ideas, making decisions to proceed with the project, and scheduling and planning of the project after selection of the ERP as the main software solution that will be implemented. In the project phase, rollout and system configuration is done. The main key players are the team members of the project, internal information technology specialists, vendors, and managers from the functional areas and business units to be integrated under ERP. The activities of the phases are software configuration, testing, integration, training, rollout, and conversion of processes. In the shakedown phase, bugs are fixed coupled with systems rework, retraining, tuning of the system performance, ands ensuring adequate staffing to ensure that temporary inefficiencies are mitigated. Monitoring of the ERP system is also conducted in this phase to ensure that no bug remains. References Davenport, T 2003, ‘Putting the enterprise into the enterprise system’, Harvard Business Review, vo.5 no.2, pp. 121-131. Dehning, B Stratopoulos, T 2003, à ¢â‚¬ËœDeterminants of a Sustainable Competitive Advantage Due to an IT-enabled Strategy’, Journal of Strategic Information Systems, vol. 12 no.3, pp. 202-241. Fryling, M 2010, ‘Estimating the impact of enterprise resource planning project management decisions on post-implementation maintenance costs: a case study using simulation modelling’, Enterprise Information Systems, vol. 4 no. 4, pp. 391–421. Fui-Hoon, F Lee-Shang, J 2001, ‘Critical factors for successful implementation of enterprise systems’, Business Process Management Journal, vol. 7 no. 3, pp. 285-296. Grant, D, Hall, R, Wailes, N, Wright, C 2006, ‘The false promise of technological determinism: the case of enterprise resource planning systems,’ New Technology, Work Employment, vol. 21 no. 1, pp. 2–15. Head, S 2005, The New Ruthless Economy: Work and Power in the Digital Age, Oxford UP, Oxford. Kraemmerand, P et al. 2003, ‘ERP implementation: an integrat ed process of radical change and continuous learning’, Production Planning Control, vol. 14 no.4, pp. 228–248. Markus, L Tanis, C 2000, The enterprise system experience from adoption to success: Framing the Domains of IT Management: Projecting the Future Through the Past, Pinnaflex Educational Resources, Inc., Cincinnatti, OH. Monk, E Wagner, B 2009, Concepts in Enterprise Resource Planning, Course Technology Cengage Learning, Massachusett, Boston. Mureell, S 2001, E–Business and ERP: Rapid Implementation and Project Planning, John Wiley and Sons, Inc, New York, NY. Somers, M, Nelson, K, Ragowsky, A 2000, ‘Enterprise resource planning (ERP) for the next millennium: development of an integrative framework and implications for research’, Proceedings of the Americas Conference on Information Systems (AMCIS), vol. 1 no. 1, pp. 998-1004. Turban, J et al. 2008, Information Technology for Management, Transforming Organisations in the Digital Economy, J ohn Wiley Sons, Inc, Massachusetts. Vilpola, I 2008, ‘A method for improving ERP implementation success by the principles and process of user-centred design’, Enterprise Information Systems, vol. 2 no.1, pp. 47–76. Yusuf, A, Gunasekaran, Y, Abthorpe, M 2004, ‘Enterprise Information Systems Project Implementation: A Case Study of ERP in Rolls-Royce’, International Journal of Production Economics, vol. 87 no. 3, pp. 75-81. Definition of Terms Shakedown: Removal of bugs in systems under implementation Project phase: a phase in the implementations of MIS that entails running of a system under implementation by the end users to determine its efficiently and effectiveness Chartering: A decision that entails the definition of business problems and constraints of the possible solutions. ERP: A software application, which enables an organisation to manage effective and also efficient utilisation of resources including human resource, financial resources, an d material resources among others Customisation: Configuration of MIS systems to meet the clients’ business needs Bugs: Errors that influence the functionality of a software application Change management: A group of techniques that are deployed by managers to effect changes in a firm Decision support systems: A type of MIS, which makes it possible for managers to make decisions based on statistical projections and data analysis. This assessment on Information Management Systems in the US medi-corp was written and submitted by user Giselle H. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.