Administration of medicines is a key element of nursing

Administration of medicines is a key element of nursing Drug administration forms a major part of the clinical nurses role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (OShea 1999). So as a student nurse this became our duty and something that we practiced and become competent in carry out as explained in figure 1, we were also faced with the challenges of administering medication. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I wasnt competent enough to dispensing a certain drug it would be in my responsibility to speak up and let the registered nurses know, so that I could shadow them and have the opportunity to learn and then in future be able to practice and administer. The reflective model I have chosen to use is Gibbs model (Gibbs 1988). Gibbs model of reflection incorporates the following: description, feelings, evaluation, and conclusion. (Gibbs 1988). The model will be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. Discussion will include the knowledge underpinning practice and the evidence base for the clinical skill, that I have learnt and supporting this with current literature. The first stage of Gibbs (1988) model of reflection requires a description of events. I was asked to administer a drug to a patient. I had observed this clinical skill on a variety of occasions and had previously administered medication under supervision. On this occasion I was being observed by two qualified nurses, one of which was my mentor. The drug had been dispensed and was ready to be administered and the patient consented to have a student administer the medication. My mentor was talking me through the procedure step by step, and informed me that they have struggled with this patient and her compliance with medication before so I should keep an out and ensure that she swallows her medication and that she not keeping it her mouth. The Medication that this patient is on is Clozapine. Clozapine is indicated for patients with treatment resistant schizophrenia, or those who are unable to benefit from other antipsychotic medicine, as they cannot tolerate the side effects. The decision to use clozapine is not taken lightly because of the potentially life threatening side effect of neutropaenia, which requires regular blood tests to ensure its safe use. In addition, there is the risk of developing paralytic ileus and some cardiac abnormalities. (WLMT). In addition to that statement if a patient on clozapine white blood cells count falls below accepted lower limit are classified as Red alerts medication must be withdrawn, and any other prescriber in the future wishing to restart medication are aware of the patients haemotological history. Adverse drug reactions are the main limiting factor on using anti-psychotics, for this reason prescribers should keep dosages to a minimum required for efficacy starting at a low dose with gradual upward titration. An awareness of side effects is important to primary care practitioners because they have most contact with the patients, patients with long term monitoring falls within their remit. Clozapine is an atypical antipsychotic, and atypical anti-psychotics are considered of choice both accurately and for maintenance in schizophrenia. Clozapine holds a unique position among the atypical due to its ability to improve negative as well as positive symptoms (delusions, hallucinations). (Morris, D) . During the process of administering anti-psychotics I learnt that using anti-psychotics is just a component of a holistic approach to the patient with psychotic illness and that care should also include psychological treatments and social care. The patient at such does not have any issue with the drug it self but with the staff, as she is in a very psychotic state she is very paranoid and non compliant with medication this is closely monitored by staff and as stated in figure 1 I have to prompt her to ensure that medication is complied with. Service users have requested strategies from services providers to manage the risk of using psychiatric medication to inform their choice about which psychiatric medication to use. (DOH 1999). However evidence suggests that, there is choice, but generally by practitioner experience. (Hamann et al. 2005). In non compliance of medication I had to encourage the patient to make their choice to take the medications and that it was in their care plan a nd apart of their treatment. A nurse who has built a good relationship with a patient by informing and empowering them will be in a strong position to have a non judgmental conversation with them about the importance of adherence. (Mc Lellan. A 2009). I am now going to enter into the second stage of Gibbs (1988) model of reflection, which is a discussion about my thoughts and feelings. I was aware of being under the supervision of two qualified nurses and this made me feel very nervous and self conscious and I had to ensure that I was doing everything correctly and that I made no errors. Once my mentor questioned my practice, concerning if I knew the side effects of the drug I was about to administer, I became even more aware of feeling nervous and under pressure. The patient was present and I did not want the patient to feel that I did not know what I was doing. So I had to ensure before administering that I was giving the medication to the right patient and at the correct dose that it was at the right time and route. All of these had to be done to guarantee that I am competent in my ability to administer medication under the supervision of a registered nurse. This also gave me the opportunity to carry out this task in order to a chieve this so I could get it signed off by my mentor in my essentials skills cluster. The nurse patient relationship is by many considered the core of nursing; this can be done to build a good relationship and rapport with patients. (Framer.J.Kramer.S, 2001). When I was first orientated to the ward, I took it upon myself to read the patients notes so that I had little insight to the patients and their illness and index offences if any. After this I went and introduced myself to the patients because its vital that the patients are aware of who I am and my status if I am to provide nursing care for them. (Berlo 1960) puts great emphasis on dyadic communication, therefore stressing the role of the relationship between the source and the receiver as an important variable in the communication process. So to provide patients with adequate care its important that there is effective communication, that the patients is aware of everything, and that the nurse provides care and compassion in the delivery of care. There is evidence that our ability to use language actually affect s the thoughts themselves, the words we can command, and the way that we put them together affects: what we think how we think whether we are thinking So as a student nurse I was made aware that words can have an impact on care provided and the way in which these words are delivered can have an even greater impact. As explained in figure 1, when I was admitting a patient on to the ward I had to make certain that I was communicating effectively, making certain that I was delivering information in ways that were easy to understand refraining from uses of jargon, and that I was showing compassion to the patient as this could be a time of high anxiety for them, reassuring them that they are in great hands and offering them tea were among the things I did to exercise my care and compassion skill. so my main aim was to make the care of people your first concern, treating them as individuals and respecting their dignity, and working with others to protect and promote the health and well being of those in my care, their families and careers, and the wider community. (NMC 2008). However I tried to use different forms of communication to con vey information from my patients, for instance as stated in figure 1, when I had my 1-1 personal time with my patient I would use (Bein and Miller 1992) the use of open and ended questions and active listening, so that I could comprehend everything I was being told so that when I came round to me providing comprehensive and accurate written report based they would reflect everything that was being. Studies show that during interpersonal communication only 7% of the message is verbally communicated by the words used. Â  Of the 93% non-verbal communication: As a result I learnt to pick up non verbal signals Even if someone decides to say nothing they are still communicating (effective communication skills). All of which skills I can adopt to engage with patients and to help with my development in nursing. Evaluation is the third stage of Gibbs (1988 ), here I will the explain the importance of administering medication and how this combined with care, compassion and communication forms the bases of a holistic approach to care, and with the knowledge I got from supporting literature formed the foundation of my learning and practice. Burnard (2002) suggests that a learner is a passive recipient of received knowledge, and that learning through activity engages all of our senses.

Competition in Energy Drinks Essay

1. What are the strategically relevant components of the global and U. S. beverage industry macro-environment? How do the economic characteristics of the alternative beverage segment of the industry differ from that of other beverage categories? Explain. Demographics: The total sale for beverages in 2009 in the US was about 458. 3 billion gallons and it is one of the largest markets with dollar value of 1,581. 7 billion in 2009 and with a forecast of $1,775. 3 billion for 2014. 48. 2 percent of industry sales were from carbonated soft drinks and 29. 2 percent of bottle water industry sales. In 2009, The Alternative beverage industry included sports drinks, flavored or enhanced water and energy drinks made up 4%, 1. 6%, and 1. 2% of industry sales respectively. The global market for alternative beverages in 2009 was $40. 2 billion, while it was $17 billion for alternative beverages in US market. It was $ 12. 7 billion and $9. 1 billion for Asia pacific and European markets respectively. Market growth: The market growth has huge potential with the dollar value of the global market for alternative beverages grew at a 9. 8% annually between 2005 and 2009, but was expected to slow down to 5. 7% annually between 2010 and 2014. US is the country which has strongest growth internationally in term of alternative beverage sales with an annual growth rate of 16. 6% between 2005 and 2009 and a forecasted growth rate of 6. 7% between 2010 and 2014. Europe and Asia-Pacific grew at annual rates of 5. 3% and 5. 6% between 2005 and 2009 and were expected to grow at a rate of 4. 4% and 5. 1% respectively between 2010 and 2014. However poor economic conditions in the US in 2008 and 2009 led to a 12. 3% decline in sports drink sales and a 12. 5% decline in flavored and vitamin waters sales. It was also the reason why energy drinks sales increased only 0. 2% between those years. Rivalry between competitors: Coca Cola, Pepsico and Redbull are the three big players that made the industry rivalry become global. However, there were hundreds of brands like Otsuko which were specialty yet regional brands that did not have a foot print internationally but were doing well in their own terms. Beverage producers had made various attempts at increasing the size of the market for alternative beverages by extending existing product lines and developing altogether new products. Social Forces: * Global beverage companies such as Coca Cola and PepsiCo had relied on such beverages to sustain in volume growth in mature markets where consumers were reducing their consumption of carbonated soft drinks. * Expanding the market for alternatives beverages and increasing sales and market share, beverage producers also were forced to content with criticism from some that energy drinks, energy shots, and relaxation drinks presented health risks for consumers and that some producers’ strategies promoted reckless behavior, the primary concern of most producers of energy drinks, sports drinks, and vitamin-enhanced beverages was how to best improve their competitive standing in the market place. Driving Forces for this industry: * Expanding Market share. * Desire to reach out to Consumer needs and meet the demand * Personalization of the Market Segments * Branding * Market Size * Maximization of Growth Potential General Economic Conditions: * Global growth is projected to grow at 3. 5 percent in 2012, then accelerate somewhat to 3. 6 percent from 2013-2014. In 2012 It is expected that emerging economies will be slow in growth by 0. 7 percentage points on average, going from 6. 3 percent growth in 2011 to 5. 6 percent in 2012, partly as a result of slower export growth and partly because several of them have been growing above trend and the GDP Growth for the world is predicted to be at 3. 6. Things look a little slow but are picking up slowly and there is no recession in sight so far. This could really help the industries like Food, Beverages, Health surge ahead like they already are into the market with more percentage of market share and consumer usage based on the increasing numbers in the trend. Impact of Economic Factors: * Demand on beverages and alternative beverages should remain incremental or stable * Branded alternative beverages with national and international presence should do well * Business opportunities should be encouraged with fair and encouraging interest rates 2. What is competition like in the alternative beverage industry? Which of the five competitive forces is strongest? Which is weakest? What competitive forces seem to have the greatest effect on industry attractiveness and the potential profitability of new entrants? The Beverage industry is highly competitive and the segments that come into picture when it comes to competition are Distribution, Shelf management, Licenses, Brand name and Image, Pricing, Labeling and Packaging, Marketing and Advertising, Quality and taste, Trade and Consumer promotions and Branding. * Competition with non-alcoholic beverages * Competition with Carbonated beverages * Competition with regional beverage producers and private label soft drink suppliers * Competition in maintenance of distribution network * Competition on quality and pricing * Competition on Branding, Labeling, Marketing, Packaging and Promotions. Bargaining power of Buyers: Strong * Convenience store, grocery store, and wholesale buyers had considerable leverage in negotiating pricing and slotting fees with alternative beverage producers because of their bulk purchases. * New entrants with comparatively lower market shares are most affected with this like how it is mentioned in the case where the shelf space is limited to top brands like Coke, PepsiCo and Red bull for that particular market segment. The larger brands like coke and Pepsi also already have spaces worked out with them for their other products and this makes it easier for the bigger brands to get their newer products in the shelf’s too. * Delis and restaurants have low switching costs to other brands but they have less volumes compared to stores and less space, shelfs etc.and also will not have the same bargaining power that a store enjoys. * Demand is highly dynamic Bargaining Power of Suppliers: Weak * Suppliers for alternative beverages do exist in huge numbers and the competition is high * The producers of alternative beverages are important customers of suppliers and buy in large quantities. * Packaging is readily available Threat of Substitutes: Medium * Many substitutes like tea, bottled water, juices, nutrition water etc. have surfaced but the market is not as big as alternative beverages and this customer preference had weakened the competitive power of substitute beverages. * Many substitutes that can quench the thirst of the consumers * Price point of substitutes is less compared to alternative beverages Threat of New entrants: Weak * Brand leaders already exist in the industry with competitive prices and well established distribution system * Convenience stores and Shelves across the stores are already in partnership with existing big-wigs * Customer loyalty towards branded products is high * Need for large financial resources and funds * High Brand equity for already existing and successful brands Threat of Rivalry: Strong. * Competition centers among major brands based on brand image, appealing taste, packaging, R&D, Marketing and Distribution capabilities * Attempts by all the brands to increase the number and types of products in their product line * Low switching costs for the consumers of the industry * Strong marketing campaigns by each brand to gain customer loyalty The Bargaining power of consumers and rivalry that exists between the competitions in this industry contributes to the attractiveness of the industry. The numbers are promising, the industry is dynamic and increase in demand each year. The factors that affect the potential profitability of the new entrants are the Brand image, Distribution network and Product line breadth. 3) How is the market for energy drinks, sports drinks and vitamin-enhanced beverages changing? What are the underlying drivers of change and how might those forces individually or collectively make the industry more or less attractive? * Driving forces of the alternative beverage industry are dependent on the creating/sustaining market demand, dynamics of the growth rate and product innovation. * Industry leaders established: Segments within the alternative beverage industry have consolidated as markets have matured and leaders have been established. Red Bull GmbH and Hansen Natural Corporation remained independent in 2010, Coca-Cola controlled such brands as Powerade sports drink, Fuze vitamin-enhanced beverages, glaceau vitamin water and NOS. In addition, Coca-Cola distributed Hansen’s Monster energy drink in parts of the United States, Canada, and six European countries. * Changes in Long term Growth Rate: The recession had an impact on sales of sports drinks and flavored or enhanced water and has stalled growth in the market for energy drinks; there was also growing market maturity for most categories of alternative beverages. The annual rate of growth for the dollar value of the global market for alternative beverages was forecasted to decline from the 9. 8 percent annual rate occurring between 2005 and 2009 to an anticipated annual rate of 5. 7 percent for 2010 through 2014. While dollar value growth rates were expected to decline only slightly in Europe and Asia-Pacific, the annual rate of growth in the U. S. was projected to decline from 16. 6 percent during 2005 – 2009 to 6. 7 percent between 2010 and 2014 * Product Innovation: The industry is continuing to evolve with introduction of new products that enable rise of new category of products. The recent introduction of energy shots is an example of how an innovation that has given rise to an altogether new sub-segment in the industry. * The creation of new product segments, the increasing positive trends in growth rate and increasing market share for each product are a good indication and good drivers of change that increase the attractiveness of the market for an emergent industry. 4) What does your strategic group map of the energy drink, sports drink, and vitamin-enhanced beverage industry look like? Which strategic groups do you think are in the best positions? The worst positions? The strategic group maps show the industry participants competing with axes of Geographic foot print and Brand. The Map shows that Industry giants like Coke and Pepsico are positioned strongest in the industry due to already existing contracts, supply chain, distribution network and shelf spaces in retail spaces. * Red Bull is seeing a successful brand in Europe and the U. S. * Hansen’s Monster is also doing good standing up to the other market giants with distribution partnership with coke giving it the required space and opportunity to grab the market and hence can be considered at a favorable position. * Rock star has also been at a favorable position due to the same reason of distribution network partnership with PepsiCo * Companies with a single brand and regional distribution like Otsuko, Vitamin water etc. appeared to be at an unfavorable place with chances of competition gulping the market share of the small players very soon. 5) What key factors determine the success of alternative beverage producers? The Key success factors for Alternative Beverage producers are * Constant Product Innovation: A company must be able to identify what a consumer is looking for and also maintain the ability to adapt with the changing market trends. They must be able to keep up and not lag behind. * Price: Price is always a factors in many cases and in this case consumers with a low brand preference will buy a product based on its competitive pricing * Brand Loyalty: Consumers are particular about what brand they purchase and they stick to it in most of the cases. This stresses for a superior brand image and quality * Distribution system: Probably one of the most important, Effective distribution channels will not only help reduce costs but also helps a company remain competitive. * Size and Scale: Successful alternative beverage producers were required to have sufficient sales volumes to keep marketing expenses at an acceptable cost per unit basis. 6) What recommendations would you make to Coca-Cola to improve its competitiveness in the global alternative beverage industry? To PepsiCo? To Red Bull GmbH? Recommendations to Pepsi. * Pepsico have to launch a major image building campaign for the most promising products it has. * Pepsico also needs to develop its own energy shot brand try to convince Rockstar to add an energy shot to its distribution agreement. * In addition, Pepsi should negotiate for distribution rights to European and Asia-Pacific market with Rockstar or launch its energy drink brands in attractive international markets. * PepsiCo can expand its foot print and focus on other international markets in energy drinks for more international presence and to utilize the demand of a branded and standard product. * Red Bull is currently the number in the energy drinks category and they should really take advantage of that and come up with more product line extensions and more products so people can identify with that brand and try other products too. They should focus more on product innovation and product line extensions. Recommendations to Coca Cola * Coca cola should improve its product by innovating and building up good image to recapture the market share it lost in energy drinks category. * Coca cola should also try to create more rapid growth in vitamin-enhanced beverages and energy shots product. * Coke should focus on products and Branding efforts to gain market and regain lost market share in energy drinks * It should build up its strength in term of alternative beverage sales in by pursuing acquisitions and focus on building its strength of sales in Asia and react quickly to solve the problem of lacking competitiveness in the European market for alternative beverages. * Coca cola can use a combination of new flavors and formulations, brands, line extensions, improved image building, and distribution capabilities to increase sales of alternative beverages internationally. Recommendations to Red Bull GmbH * Redbull should improve the performance of its recently introduced energy shots and continue to expand into rapidly growing country markets for energy drinks. * It is necessary for the company to maintain its lead in the U. S. and European energy drink market with additional product line extensions based upon product innovation. * It should develop sports drinks or vitamin-enhanced beverages that can further exploit the appeal of the Red Bull brand 7. Using the data in Ex. 11, 12, 13 compare Pepsi, Coke, and Hansen. Who has been the most profitable? Who has better managed their expenses? Which business has shown the most growth? Which of the three would you give the strongest grade for their performance? * Using the data from Exhibit 11,12 and 13 for Coke, Pepsi and Hansen, Hansen seems to be the most profitable so far as it became the largest seller of energy drink in the US by leading most of alternative beverage categories. PepsiCo’s global market share in 2009 was 26. 5 percent, overcome by 11. 5 percent to Coca-Cola. The Coca Cola has better managed their expenses it was the third-largest seller of alternative beverage and in the top five best-selling non-alcoholic beverages worldwide in 2009. But they have lot of catching up to do. I would give the strongest grade for performance to Hansen for its market share, range of products, product innovation and distribution strategies. Hansen also managed to have higher revenue growth and higher cash flow growth. Net Revenue| 2007| 2008| 2009| CAGR| Pepsi| 39374| 43251| 43232| 3. 17%| Coca Cola| 28857| 31944| 30990| 3. 40%| Hansen| 904465| 1033780| 1143299| 4. 50%| | | | | | | | | | | Net Income| 2007| 2008| 2009| CAGR| Pepsi| 5674| 5166| 5979| 1. 76%| Coca Cola| 5981| 5807| 6824| 4. 49%| Hansen| 149,406| 108032| 208716| 11. 70%| | | | | | | | | | | Operating profit| 2007| 2008| 2009| CAGR| Pepsi| 7182| 6959| 8044| 3. 85%| Coca Cola| 18451| 20570| 19902| 2. 55%| Hansen| 230986| 163591| 337309| 13. 40%| The company growth rate analysis of the three companies in terms of revenue, income and profit show that Hansen has higher percentage of growth rate well above the industry average. Hansen has greater revenues in the industry segment and higher customer demand and financial success.

Human Health Essay

Health in human beings includes physical, social and psychological well being or fitness. Changing weather patterns, for instance, extreme events affects human health directly or indirectly through changes in air, food quality and quantity, ecosystem agriculture, livelihood and infrastructure. Research on effects of climate change Confalonieri et al provided evidence climate change has; altered distribution of some infectious disease vectors altered the seasonal distribution of allergenic pollen species and increases heat wave-related deaths (2007). Seriousness of the effects of climate change is further manifested by increase in malnutrition and consequence disorders, including disorders related to child growth and development, increase in death, diseases, and body injury from heat waves, storms, fires and drought. As climate change, some infectious disease vector has change too; this has made them more resistant to traditional drugs. The change has also lend to mixed effects on malaria, in some places, the geographical range has contracted while in other places the range has expand and still in others the transmission season has changed. Transmission of water borne diseases like typhoid and cholera increases. The research has also proved an increase in cardio respiratory morbidity and mortality associated with ground level ozone. Non –communicable diseases, such as heart disease diabetes stroke and cancer are estimated to contribute about half of the global burden of all disease at all ages. Despite this, communicable diseases affecting human health are a great threat to public health in many parts of the world. According to the report, almost two million deaths a year are feared to result from diarrheal diseases and other communicable diseases and other conditions that are attributed to unsafe drinking water and lack of basic sanitation. Malaria, a disease whose geographical rage is affected by climate causes an estimated one million deaths annually especially in young children. Mal-nutrition and drought leading to adverse negative effects on human health, is greatly attributed to climate change. In the report, it is estimated that an increase in frequency or intensity of heat waves will increase the risk of mortality and morbidity, especially in old age group and the urban poor. An increase in climate extremes, for instance storm, floods and drought would cause more deaths injuries, population displacement and adverse effects on food production, fresh water availability and an increase in the risk of infectious disease particularly in low income countries. Considering the current trends of emissions to continue, more harm will be done to the environment; air quality will worsen, ozone and other particulate pollutants will increase, increasing mortality and morbidity amongst human beings. From the report, a clear relationship between climate and human health is described, but in it is common knowledge that disease have been here as long as man has existed. It is therefore important to consider and see climate change as a catalyst and not necessary the cause of ill health in human beings. Despite this, more understanding of the extent, rate, limiting forces and major drivers of adaptation of human population to a changing climate is needed. This will reduce the impacts of climate change on human health.

Shocking Principles Terrifified Victorian Readers in The...

The sophisticatedly-constructed novel ‘The Strange Case of Dr Jekyll and Mr Hyde’ was devised in 1886, during the revolutionary Victorian era, by the author, Robert Louis Stevenson. Stevenson developed a desire to write in his early life and ‘Dr Jekyll and Mr Hyde’ cemented his reputation. The novel is widely known for its shocking principles that terrified and alarmed the Victorian readers. ‘Dr Jekyll and Mr Hyde’ plays with the idea of the dual nature of man, his two identities. On the surface, Dr Jekyll is a conventional, Victorian gentleman, but below the surface lurks the primitive, satanic-like creature of Mr Edward Hyde. One of the elements that play a significant part in the novel is setting. Stevenson subtly uses the setting to†¦show more content†¦Powerful adjectives such as ‘blistered’ and ‘distained’ (disease decay bit etc). The creation of mysteriousness and tension is crucial to the Gothic genre. However, the front of Jekyll’s house ‘wore a great air of wealth and comfort, though it was plunged in darkness’, which shows that evil was not far away from good and this creates tension and the image that evil is fighting good in a chaotic battle. In addition to this, Stevenson splits up the locations to symbolise the good and evil. The main house shows a typical, Victorian structure. However, the laboratory and the cabinet represent the evilness behind the shield of normality. The cabinet is very significant in the novel, as it is locked until the final chapter, when Mr Utterson and Poole break down the door. It is found to contain the ‘cheval-glass’ (the mirror), in which Jekyll would watch himself transform into the repulsive figure of Hyde. Hyde’s apartment was set in Soho, a very sleazy, corrupted part of London at the time. Living in Soho links Hyde was the lowest levels of society: prostitutes, foreigners and primitive, immoral behaviour. Also, Soho had eerie weather- ‘a great chocolate-coloured pall lowered over heaven’, representing the malicious crimes being committed and the blocking out of God. This reflects the mysterious, depraved attributes of Hyde’s