Quality of Nursing and Diversity

Quality of Nursing and Diversity Critically discuss how an understanding and application of the concepts of diversity, cultural competence and equality can help to improve the quality of nursing care in today’s diverse healthcare settings for a diverse service-user population The Office of National Statistics (2014) displays how the population of Britain is becoming increasingly diverse due to migration, with 560,000 people migrating to Britain between March 2013 and March 2014; a significant increase from 492,000 people in the previous 12 months. Globalisation; which is the increasing integration of economies and societies has a profound effect on migration and health. For example the ease of accessibility of borders for services and trade removes the boundaries for migration and increases the production and marketing of products such as tobacco which have an adverse effect on health (Wamala and Kawachi 2007). The increasing movement of countries into the European Union (EU) also removes the boundaries to migration as the European commission state that individuals who hold European citizenship have rights to free movement and residency within the EU(EU 2014). The acceleration of globalisation and the growth in migration means the NHS have to care for an increasingly diverse service-user population who have a range of health needs which presents many issues and challenges for nursing care. Blakemore (2013) recognised how research by Macmillan cancer support found that patients from Black minority ethnic (BME) groups experience increased challenges and poor treatment compared to white British cancer patients; such as lack of compassion and poor and ineffective communication. This is an example of how diverse groups can receive poor quality care and highlights the need for nurses to understand and apply the concepts of diversity, cultural competence and equality to evade this diminished care. This essay will explore, discuss and critique these concepts when looking at how they can improve the quality of nursing care in today’s diverse healthcare settings for a diverse service-user population. Diversity is defined by Dayer-berenson (2014) as the ‘individual differences of the human race’ which should be ‘accepted, respected, embraced and celebrated by society’. The differences encompass many factors such age, religion, ethnicity and sexual orientation, all which shape an individual to be unique. This definition however fails to acknowledge that differences exist within each unique factor. For example in ethnic groups; where although common characteristics such as language and origin are shared, differences within the ethnic group still do exist such the extent to which the individual practices their religion, and the culture to which the individual identifies to (Henley and Schott 1999). The National Health Service (NHS)(2011) expand on this definition by recognising that diversity includes ‘visible and non-visible’ differences. Recognition of this is important in clinical practice as non –visible differences such as values and beliefs will not be established unless nurses effectively communicate and assess there patients values, needs and prefences. This will prevent the assumption that all members of one ethnicity act as another as mentioned previously, and therefore avoid stereotyping. Henley and Schott (1999) recognise how stereotyping will result in inadequate nursing care as people distance themselves from those they see as different, causing them to have a lack of consideration and respect for the individual, thus diminishing care. Furthermore, when assessing the values and beliefs of diverse patients, nurses must avoid holding an ethnocentric attitude. Ethnocentrism is when people identify their own cultural ways as superior to others, creating an attitude that any other beliefs and values are wrong. This leads to inadequate care as other diverse beliefs, values and therefore needs; will be rendered as insignificant and may be ignored (Royal college of Nursing (RCN) 2014). Ethnocentric behaviour however is not always recognised by the individual and is therefore difficult to challenge, as through socialisation into their own cultural values and beliefs a viewpoint of what is ‘normal’ and ‘appropriate’ is created. This viewpoint is then used to often negatively judge diverse cultures that the individual comes across (Henley and Schott 1999). On the other hand Sharif (2012) views ethnocentrism as having a positive influence on healthcare in the United Kingdom. When looking at BME groups, South Asians are a high risk group for public health diseases such as cardiovascular disease, diabetes and chronic kidney disease. Sharif recognises the need for ethnocentric interventions to educate South Asian communities and to distinguish them as a group to further investigate the differences in epidemiology, pathophysiology and health outcomes. This view is opposed by The Nursing and Midwifery Council (NMC)(2010) who state in their standards for pre-registration nurses that nurses must strive for culturally diverse nursing care by practicing as holistic, non-judgemental and sensitive nurses, avoiding assumption, recognising individual choice and acknowledging diversity. Therefore nurses must adhere to this code by avoiding stereotypical and ethnocentric attitudes which can be done through assessing and recognising patients as individuals. This will result in high quality care which is essential for a diverse service user population. Respecting individual patient diversity results in respecting equality which is the elimination of discrimination and disadvantage through respecting the rights of individuals and promoting equal opportunity for all. Nurses working within an organisation must comply to the Equality Act 2010 which protects 12 diverse characteristics such as age, disability and religon from discrimation and disadvantage (Equality and Human Rights Commison 2014). In healthcare this is done through the implementation of policies and guideance, however Talbot and Verrinder (2010) highlight how equality policies can express the need for patients to receive equal care regardless of characteristics and background. This ignores personal choice and therefore disregardards individuality and diversity; producing poor quality care. When looking at equality further nurses can promote equality through ensuring everyone has equal and full access to health care. It is recognised that BME patients have a poor uptake of healthcare services compared to white British patients for several reasons such as; language barriers, negative experiences and inadequate information (Henley and Schott 1999,Washington and Bowles et al 2008). Dayer-berenson (2014) however identifies that barriers to healthcare are not just due to racial factors but also socio-economic factors. Nimakok and Gunapala et al (2013) expand on this further by recognising that individuals from BME communities are more likely to be of poor socio-economic status than their white counterparts ; due to factors such as low income and poor housing quality. Nurses must therefore be in the position to promote equality through endorsing equal access to healthcare and complying to equality policies. This must be done whilist respecting individual patients and their di versity which produces culturally competenet nurses and thus high quality care for the diverse service user population. Cultural competence is defined by Papadopolus and Tilki et al. (2003) as the act of respecting the cultural differences of patients in order to provide effective and appropriate care. This is a brief definition which fails to include all aspects of being a culturally competent practicioner, which arguably involves more than respecting cultural differences which will later be explored (McClimens and Brewster et al. 2014). Leininger (1997) states that cultural competence is the goal of providing culturaly congruent, compent and compassionate care through holisticly looking at culture, health and illness patterns and respecting the similarities and differences in cultural values and beliefs.This definition fails to recognise that cultural competence Is never a completed goal but an ongoing process (Dean 2010), however it recognises the importance of looking at the similarties within cultures. This increases the nurses ability to understand and meet the patients full range of needs thus producing culturally competent care (Henley and Schott 1999). Cultural competent nursing care is essential for enusuring high quality care in the increasingly diverse service user population, with The NHS stating that it provides a comprenhesive service for all regardless of background and characteristcs and In consideration of each individuals human rights. Respect for equality and diversity are two important aspects of The NHS`s vison and values as highlighted in this statement; and through culturally competent care these values can be achieved (McClimens and Brewster et al. 2014, NHS 2014). Educating health care professionals on culturally competent care is therefore important with Hovat and Horey et al. (2014) looking at the effects of educational cultural competence interventions for healthcare proffesionals on healthcare outcomes. The review found that health behaviour such as concordance to treatment was improved however they also acknowledged that there quality of evidence was poor and that cultural competence is still a developing stratergy, therefore further research is needed to establish its effectiveness on healthcare outcomes. Dayer-Berenson (2014) however, states how culturally competent care does produce positive healthcare outcomes and therefore high quality care as through culturally competent practice, cultural sensitivity can be developed. This will bridge the gap between the healthcare professional and the patient which allows the patient to feel understood, respected and supported. There are various models which offer an understanding of cultural competence and a process for developing cultural competence to allow for high quality care. Campinha-Bacote developed the `The Process of Cultural Competence in the Delivery of Healthcare Services model’ in 1998 which looks at how the healthcare professional must work within the cultural context of the patient and ‘become’ culturally competent rather than ‘be’ culturally competent. Campinha-Bacote sees becoming culturally competent as an ongoing process which involves the constructs of cultural awareness, knowledge, skill, encounters and desire Campinha-Bacote (2002). When looking at cultural awareness; which is the process of the nurse exploring there own cultural and professional background and any bias towards other cultures, Dayer-Berenson (2014) agrees nurses need to be aware of there own culture so that they can step outside of it when necessary and care for patients only in terms of their needs. This will reduce misunderstandings and misjudgements and therefore failures in care, allowing for high quality care for the diverse service user population. On the other hand this model has some weaknesses. When looking at the construct of cultural skill which Campinha-Bacote (2002) defines as the collection of relevant cultural data through cultural assessment in regards to the patients presenting problem, Leishman (2004) identifies some issues. Her study on perspectives of cultural competence in healthcare found that nurses do not agree that the personal beliefs and values of patients should be impinged upon as Camphinha-Bacote suggests in her model. Leishmans study found that this may impact the patients overall impression on the care they receive and that individual patient needs irrespective of culture should be the focus of care. This view argues that patient centered care is favourable over cultural competence when caring for a diverse patient population . Patient centered care describes care which is centred around the individual and their needs with inclusion of families and carers in decisions about treatment and care (Manley and Hills et al. 2011). It is a philiosphy which is embedded at the forefront of all patient care, with a recent inquiry comminsed by the Royal College of General Practicioners (2014) emphasising the importance of patient centred care in the 21st century to meet the challenging and changing needs of patients; such as the increase in the diverse patient population. Kleinmans explanatory model of illness offers an alternative approach for looking at cultural competence as it supports the delivery of person centred care. The model contains steps that the healthcare professional can use to communicate with their patients. The steps look at several issues such as; establishment of the patients ethnic identity and what It means to them, how an episode of illness can effect the patient and their family, what the illness means to the patient, and how a cultural competent approach may help or hinder the patients care (NHS Flying Start 2014 , Kleinman and Benson 2006). By eliciting the patients and their families views and explanations of their illness the model allows for patient centred care. Also the cross cultural communication and recognition of any conflicts in values and beliefs which need negotiating produces culturally competent care (Hark and DeLisser 2009, Misra-Herbert 2003). The model has further strengths which also allow for high quality care as recognised by Kleinman and Benson (2006) who state that the model allows practicioners to set there knowledge alongside the patients own views and explanations which avoids an ethnocentric attitude. On the other hand the model is focused on the interaction between doctors and patients so it is therefore questionable as to wether this model can be applied to the nursing care of a diverse service user population (Misra-Hebert 2003). The acceleration of globalisation and therefore increase in migration means that the NHS have to care for an increasingly diverse service user population. To give high quality nursing care to their patients nurses must understand apply the concepts of diversity, equality and cultural competence. This essay has shown how this can be done by ensuring their practice is underpinned by legal and ethical principles and through respecting the diversity of all through treating patients as individuals and avoiding stereotypical and ethnocentric attitudes. Respecting diversity can also endorse equality which nurses can also encourage through promoting equal access to healthcare for all. Finally nurses must be culturally competenet practicioners by respecting diversity and equality and through the implication of models although further research is needed as cultural competence is a developing concept with other principles such as patient centered care also being seen as essential in nursing pra ctice. 2,180 1

Online Shopping Essay

Online shopping (sometimes known as e-tail from â€Å"electronic retail† or e-shopping) is a form of electronic commercewhich allows consumers to directly buy goods or services from a seller over the Internet using a web browser. HISTORY English entrepreneur Michael Aldrich invented online shopping in 1979. His system connected a modified domestic TV to a real-time transaction processing computer via a domestic telephone line. his enabled ‘closed’ corporate information systems to be opened to ‘outside’ correspondents not just for transaction processing but also for e-messaging and information retrieval and dissemination, later known as e-business In March 1980 he went on to launch Redifon’s Office Revolution, which allowed consumers, customers, agents, distributors, suppliers and service companies to be connected on-line to the corporate systems and allow business transactions to be completed electronically in real-time. [3] During the 1980s[4] he designed, manufactured, sold, installed, maintained and supported many online shopping systems, using videotex technology The first secure retail transaction over the Web was either by NetMarket or Internet Shopping Network in 1994.[7]Immediately after, Amazon.com launched its online shopping site in 1995 and eBay was also introduced in 1995.[6] Alibaba’s sites Taobao and Tmall were launched in 2003 and 2008, respectively. Reasons for online shopping 1) Convenience: Where else can you do shopping, even at midnight, wearing your jammies? You don’t have to wait in a line or wait till the shop assistant helps you with your purchases. You can do your shopping in minutes even if you are busy, apart from saving time and avoiding crowds. Online shops give us the opportunity to shop 24 x 7 and also reward us with ‘no pollution’ shopping. 2) Better Prices: I get cheap deals and better prices from online stores because products come to you directly from the manufacturer or seller without middlemen involved. Many online shops offer discount coupons and rebates. 3) Variety: One can get several brands and products from different sellers at one place. You can get in on the latest international trends without spending money on travel; you can shop from  retailers in other parts of the country or even the world without being limited by geographic area†¦ These stores offer a far greater selection of colors and sizes tha n you will find locally. If you find that the product you need is out of stock online, you can take your business to another online store where the product is available. 4) Fewer Expenses: Many times when we opt for conventional shopping we tend to spend a lot more than the required shopping expenses, on things like eating out, traveling, impulsive shopping etc. 5) Comparison of Prices: Online shops make comparison and research of products and prices possible. Online stores also give you the ability to share information and reviews with other shoppers who have firsthand experience with a product or retailer. 6) Crowds: If you are like me, you would like to avoid the crowds when you do the shopping. Crowds force us to do a hurried shopping most of the time. Crowds also create a problem when it comes to finding a parking place nearby where you want to shop and going back to your vehicle later loaded with shopping bags. 7) Compulsive Shopping: Many times when we go out shopping we end up buying things which we do not require because of the shopkeepers’ upselling skills — or we’ll compromise on our choices because of the lack of choices in those shops. 8) Discreet Purchases: Some things are better done in privacy. Online Shops enable me to purchase undergarments and lingerie or adult toys without the embarrassment that there are several people watching me and my choices. Product selection Consumers find a product of interest by visiting the website of the retailer directly or by searching among alternative vendors using a shopping search engine. Once a particular product has been found on the website of the seller, most online retailers use shopping cart software to allow the consumer to accumulate multiple items and to adjust quantities, like filling a physical shopping cart or basket in a conventional store. A â€Å"checkout† process follows (continuing the physical-store analogy) in which payment and delivery information is collected, if necessary. Some stores allow consumers to sign up for a permanent online account so that some or all of this information only needs to be entered once. The consumer often receives an  e-mail confirmation once the transaction is complete. Payment Billing to mobile phones and landlines[13][14] Cash on delivery (C.O.D.) Cheque/ Check Debit card Direct debit in some countries Electronic money of various types Gift cards Postal money order Wire transfer/delivery on payment Invoice, especially popular in some markets/countries, such as Switzerland Bitcoin or other cryptocurrencies Product delivery Once a payment has been accepted, the goods or services can be delivered in the following ways. For physical items: Shipping: The product is shipped to a customer-designated address. Retail package delivery is typically done by the public postal system or a retail courier such as FedEx, UPS, DHL, or TNT. Drop shipping: The order is passed to the manufacturer or third-party distributor, who then ships the item directly to the consumer, bypassing the retailer’s physical location to save time, money, and space. In-store pick-up: The customer selects a local store using a locator software and picks up the delivered product at the selected location. This is the method often used in the bricks and clicks business model. For digital items or tickets: Downloading/Digital distribution:[15] The method often used for digital media products such as software, music, movies, or images. Printing out, provision of a code for, or e-mailing of such items as admission tickets and scrip (e.g., gift certificates and coupons). The tickets, codes, or coupons may be redeemed at the appropriate physical or online premises and their content reviewed to verify their eligibility (e.g., assurances  that the right of admission or use is redeemed at the correct time and place, for the correct dollar amount, and for the correct number of uses). Will call, COBO (in Care Of Box Office), or â€Å"at the door† pickup: The patron picks up pre-purchased tickets for an event, such as a play, sporting event, or concert, either just before the event or in advance. With the onset of the Internet and e-commerce sites, which allow customers to buy tickets online, the popularity of this service has increased. Types of Buying Behaviour. There are four types of buying behaviour. 1. Complex buying behaviour is where the individual purchases a high value brand and seeks a lot of information before the purchase is made. 2. Habitual buying behaviour is where the individual buys a product out of habit e.g. a daily newspaper, sugar or salt. 3. Variety seeking buying behaviour is where the individual likes to shop around and experiment with different products. So an individual may shop around for different breakfast cereals because he/she wants variety in the mornings! 4. Dissonance reducing buying behaviour is when buyers are highly involved with the purchase of the product, because the purchase is expensive or infrequent. There is little difference between existing brands an example would be buying a diamond ring, as people believe there is little difference between diamond brand manufacturers.

What You Should Do About 500 Word Scholarship Essay Samples Starting in the Next 8 Minutes

What You Should Do About 500 Word Scholarship Essay Samples Starting in the Next 8 Minutes Details of 500 Word Scholarship Essay Samples Stick to these essay ideas and you would have sufficient reason to think that your next 500 word essay would develop into a reference for future students. You don't need to possess the ideal writing skills to be able to be creative and compose an effective essay. In each one of these cases or in the event you simply want to know how to compose a 500 word essay, just go on reading and we will provide you with the fullest answer! Creating 500 words essay may be a pain-free experience should you do it right. It's possible for you to look at ending the essay with a question if the sort of essay you're writing allows for that. For quite a few, telling a story is the simplest and best method to compose a scholarship essay. Possessing good essay examples provides the reader an in-depth and on-the-court idea about what a well structured and coherent essay appears like. Otherwise, you'll never possess the foggiest idea on how best to compose a 500 word essay. In a nutshell, the meat of the essay was not there. What's an excellent instance of a persuasive essay. A superb essay is one which leaves a long-lasting impression. Any 500 word essay example would confirm an introduction of a brief essay must not include any long introductory statements or explain the present circumstance. You don't wish to compose a whole essay just to find out you were completely off topic. Your thesis is the very first thing you ought to consider in your essay. Outlining does not absolutely indicate your essay goes into an essential chronologic order, as an example. The very first thing you ought to understand, besides a 500 word essay length, is the fact that it requires an outline. Be sure that your essay is neatly typed, and that there's a great deal of white space' on the webpage. If you would like to conserve time and be sure regarding the standard of the content, you're welcome to purchase a 500 word essay format from our company. The total format of your essay, for example, font size and margins, will solely count on the instructions offered to you. Word Scholarship Essay Samples Ideas That means you can order for our high school scholarship essay examples without needing to be worried about your private info. The essay is your opportunity to demonstrate how you are the perfect representative. If you would like to succeed and know how to write a scholarship essay, it's also wise to find familiarized with the most frequently made mistakes. Continue reading to find eight steps to help you compose a better scholarship essay so you can find the money you have to fund your international education. Even in the event that you use essay samples, attempt to compose your paper all on your own. While scholarship essay format won't provide you any credentials, they need to be able to steer you properly on the best way to compose the suitable essay. You may use the feedback to enhance the essay before submitting it. Be sure to follow along with the appropriate format, consisting of the general elements of an essay. When using a 500 word personal statement sample can show you exactly what to include, they don't really provide any emphasis in how it ought to be written. To begin with, any word processor has the ability to calculate the range of words for you, and that means you don't need to do it manually. Taking the time and effort in writing a really distinctive statement within the established word limit is critical to your application. Utilizing a 500 word personal statement example is a great approach to comprehend what should be included and how to present it, but you also have to make certain your private statement is about you. The Fight Against 500 Word Scholarship Essay Samples Whenever you opt to ask us for expert aid, don't hesitate to speak to our support managers. Board members are going to have place to create announcements and bring up community troubles. A seasoned professional will make an error-free assignment very quickly and can help you boost your grades. For instance, if you're asking for a general academic scholarship, you may want to chat about a particular class you took that really piqued your interest or inspired your present academic and career targets. What to Expect From 500 Word Scholar ship Essay Samples? When you write and revise your essay, you want to have a rest from it so you can return with a fresh set of eyes. Having us to address any of the issues that you may face when coming up with scholarship essay topics will be wise for you. You might feel tempted to use somebody else's words or ideas but modern professors are in a position to detect copied parts using latest plagiarism program. Although some students may believe that writing an essay is an easy job, as it offers an opportunity to freely share your thoughts, it may grow to be quite a challenging test. Up in Arms About 500 Word Scholarship Essay Samples? A scholarship essay is a significant document that's used in the processes of scholarship application. It is by far the most difficult part of the application. Writing a scholarship essay can be quite difficult especially if you prefer to do it well. It might not be a simple task for many students. 500 Word Scholarship Essay Samples Explaine d Generally, you'll find a whole lot of background from the scholarship Web site or the printed material supplied by the scholarship group. In a couple seconds you'll have, a list of all of the scholarships which are available, the activity now is to filter the awards that you're qualified for. If you get this scholarship, you're expected to perform 100 hours of community service each year. Try to remember, on the exterior of the envelope, list the name of the particular scholarship you're inquiring about.

The Effect of Peer Presure in Education - 17388 Words

FACTORS AFFECTING ACADEMIC PERFORMANCE OF UNDERGRADUATE STUDENTS AT UGANDA CHRISTIAN UNIVERSITY BY KYOSHABA MARTHA BBA (UCU) 2005/HD04/4262U DISSERTATION SUBMITTED TO GRADUATE SCHOOL IN PARTIAL FUFILMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTER OF ARTS IN EDUCATIONAL MANAGEMENT OF MAKERERE UNIVERSITY DECEMBER 2009 DECLARATION I, Martha Kyoshaba, hereby declare that, this dissertation is my original work and has never been presented to any university or institution for any academic award. Sign:†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. Martha Kyoshaba Date:†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 1 APPROVAL This dissertation has been written under our supervision and has been submitted for the award of the degree of Master of†¦show more content†¦Ã¢â‚¬ ¦ †¦ ... †¦ 50 50 50 58 58 60 Discussion of findings †¦ Conclusions†¦ †¦ Recommendations †¦ †¦ Areas of further research REFERENCES †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ 61 APPENDICES ... ... ... †¦ †¦ ... †¦ †¦ ... †¦ †¦ ... †¦ †¦ ... †¦ †¦ †¦ ... †¦ †¦ †¦ 67 67 72 73 Appendix A : Questionnaire †¦ Appendix B : Reliability Analysis Appendix C: UCU students’ enrolment analysis 2006/2007 Appendix D: Pearson product moment correlation between former school background and academic performance †¦ †¦ †¦ 76 Appendix E: Letter of authorization from Dean, School of Education to carry out the research †¦ †¦ †¦ †¦ †¦ 77 7 LIST OF TABLES Table 1: Admission points and academic performance of some students who graduated in 2007 †¦ Table 2: Respondents by gender †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ †¦ 4 31 32 33 34 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Table 3: Respondents according to age†¦ †¦ †¦ †¦ †¦ †¦ Table 4: Respondents according to faculty of study †¦ Table 5: Respondents according to the year of study†¦ Table 6 : Level of academic performance as perceived by the students†¦ †¦ ... 35 36 Table 7: