Nature of Management - Free Essay Example

Sample details Pages: 1 Words: 398 Downloads: 4 Date added: 2017/09/16 Category Advertising Essay Did you like this example? Nature of Management 1. Universality: Management is an universal phenomenon in the sense that it is common and essential element in all enterprises. Managers perform more or less the same functions irrespective of their position or nature of the organization. Don’t waste time! Our writers will create an original "Nature of Management" essay for you Create order The basic principles of management can be applied in all managerial situations regardless of the size, nature and location of the organization. Universality of managerial tasks and principles also implies that managerial skills are transferable and managers can be trained and developed. . Purposeful: Management is always aimed at achieving organizational goals and purposes. The success of management is measured by the extent to which the desired objectives are attained. In both economic and non-economic enterprises, the tasks of management are directed towards effectiveness (i. e. , attainment of organizational goals) and efficiency (i. e. , goal attainment with economy of resource use). 3. Social process: Management essentially involves managing people organized in work groups. It includes retaining, Developing and motivating people at work, as well as taking care of their satisfaction as social beings. All these interpersonal relations and interactions makes the management as asocial process. 4. Coordinating force: Management coordinates the efforts of organization members through orderly arrangement of inter-related activities so as to avoid duplication and overlapping. Management reconciles the individual goals with the organizational goals and integrates human and physical resources. 5. Intangible: Management is intangible. It is an unseen force. Its presence can be felt everywhere by the results of its effort which comes in the form of orderliness, adequate work output, satisfactory working climate, employees satisfaction etc. 6. Continuous process: Management is a dynamic and an on-going process. The cycle of management continues to operate so long as there is organised action for the achievement of group goals. 7. Composite process: Functions of management cannot be undertaken sequentially, independent of each other. Management is a composite process made up of individual ingredients. All the functions are performed by involving several ingredients. Therefore, the whole process is integrative and performed in a network fashion. 8. Creative organ: Management creates energetics effect by producing results which are more than the sum of individual efforts of the group members. It provides sequence to operations, matches jobs to goals, connects work to physical and financial resources. It provides creative ideas, new imaginations and visions to group efforts. It is not a passive force adopting to external environment but a dynamic life giving element in every organization.

The Battle Over Russian Foreign Policy Essay Topics and How to Win It

The Battle Over Russian Foreign Policy Essay Topics and How to Win It What Everybody Dislikes About Russian Foreign Policy Essay Topics and Why For that reason, it's important to make them experience its different facets to better their knowledge. A superb idea does not need to be contained or restricted to a single religion because its origin is specific. Strategy There are lots of unique strategies which you will disclose in your work. Learning There are plenty of techniques and approaches to learning and grasping the exact same materials. The Importance of Russian Foreign Policy Essay Topics Large parts of the labor force in the present developing countries work in the informal sector. Living in region of a little community there are numerous issues to address, local individuals are still living in their previous traits, that's traditionally, and to fit in is difficult with individuals of different mentalities. There are many explanations as to why a country would have t o get foreign support, such as environmental issues, medical guidance, and the most important one being poverty. Many developing countries all around the world receive foreign aid. Russian Foreign Policy Essay Topics For initiatives created to support sustainable governance to be prosperous, they have to be attuned to the gendered trade-offs related to different nation-building strategies. In some instances, those operational records is going to be the focus of in-depth research. Your dissertation might concentrate on the interpersonal, psychological and institutional elements that result in particular varieties of foreign policy outcome, like decisions to heighten a rivalry or dispute. It is imperative to know to know the entire process of decision. The crisis provides a chance to implement reforms that would not be possible in a climate of stability. Russia due to increased prices was able to attain greater revenues and enhance its economical circumstance. The Canadian foreign policy is just one of the world foreign policies that have a wonderful history behind them. There are a number of reasons to why they need foreign help, but the principal ones are environmental difficulties, medical aid and poverty. Using Russian Foreign Policy Essay Topics In addition, it may also be dependent on difference of opinion between people. Regardless, the secret to a thriving speech is receiving the audience to comprehend the issue, and to instill in them an urge to solve it. The majority of them visit at least one time every month whilst others visit every week and some even pay a visit to daily. It may be a rough choice, but you'll have the ability to write about something in which you're interested. Military activity on each side of the border is going to be viewed as a provocation and an element of hybrid warfare. Poverty is often as a result of conditions where you reside, and consequently your quality of living is poor. Reducing oil dependence will take some time. Russia is an increasing threat. Russian Foreign Policy Essay Topics Features Now a more sophisticated work program is required. For instance, in college, you might be requested to compose a paper from the opposing perspective. Always be certain you have a look at the review my essay section of any writing service website you're thinking about using. You need to do your homework before planning your travel. Therefore, every paper needs to be written carefully. It's vital that the service you decide on knows for sure they're only choosing the very best essay writers. Utilizing a writing service is the best means to have a well-written essay to use as a guideline to guarantee the essays you write are hitting all the vital points and are at the appropriate depth necessary for your academic grade. Defend your status in the type of a 500 word newspaper editorial. Reading a book involves a good deal of attention, thus a library is the best location for reading books and exploring the world. Students are unable to think of an excellent item of prejudice essays, not because they can't write essays but probably on account of the simple fact they're unable to create fantastic titles for essays on prejudice. They often find that most of their work on these essays is done before they even start writing. But What About Russian Foreign Policy Essay Topics? Applicants may select a single research proposal on a single research topic. These topics are designed to help students identify some helpful sources. Therefore, students who study industry and other associated subjects may be interested in writing on a number of the next topics. General information Students that are new to the topic of social studies need to be ready for in-depth education at their very first lessons. Free example US foreign policy research paper is a significant supply of knowledge on this issue. It might look like a daunting job, but perhaps the toughest area of the job is choosing from the many social studies topics out there. It also needs to be a topic where the speaker may get highly proficient, and there ought to be adequate research and data to back up any argument for or against the topic.

The Use of Intraosseous Vascular Access Free Essays

The Use of Intraosseous Vascular Access Table of Contents Title Page†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 1 Table of Contents†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 2 Executive Summary†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. We will write a custom essay sample on The Use of Intraosseous Vascular Access or any similar topic only for you Order Now 3 Body of Paper†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 4 Plan†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 6 Do†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 7 Check†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 7 Act†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦8 Research to Support Change†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦8 Change Theory†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 Conclusion†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 18 References†¦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‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 20 Timeline†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 22 Executive Summary First introduced by Drinker and colleges in 1922, intraosseous (IO) vascular access was a method used during World War II for accessing the non-collapsible venous plexuses within the bone marrow cavity to provide access to a patient’s systemic circulation. This method later fell out of use after the development of intravenous catheters. Then during the 1980s IO vascular access was again introduced as a rapid way of gaining vascular access for swift fluid infusion particularly during resuscitation attempts of pediatric patients. (Tay Hafeez, 2011) Plan-Being by implementing a policy for the use of IO vascular access within the Emergency Department of Hays Medical Center (HMC) for critically ill patients. This would expedite critically ill and severely injured patients in receiving the intravenous fluids and medications. Currently there is no policy in place for the placement of IO devices as opposed to peripheral intravenous catheters, or central venous catheters. However, if there was a policy in place the staff would know when it was appropriate to insert an IO device, as opposed to having to make a difficult decision based on personal judgment. Do- Create a group of physicians and nurses to write a policy outlining when it is appropriate for the placement of an IO device compared to traditional techniques for gaining venous access. Once the policy has been written implement its use within HMC’s ED. Check- Keep a careful record of when an IO device is placed, in accordance to the new policy. Monitor the outcomes of these patients. Evaluate the effectiveness of the new policy and determine if any changes need to be made. Act- Based on the information obtained during the check phase of this project, management will determine whether the policy will be continued, improved, or discontinued. The Use of Intraosseous Vascular Access in Critically Ill Patients The origin of the intraosseous cavity as an access sight to the circulatory system was originally discovered during World War II. Medical personnel during this time used an IO route to resuscitate patients suffering from hemorrhagic shock. It was first documented in medical journals by Drinker and colleges in 1922. It was later rediscovered by American pediatrician James Orlowski. During his time working in India, Orlowski observed medical personnel during a cholera epidemic using IO access to save patients in whom IV cannulation was impossible and who might have died without access. He later wrote about his experiences in a paper entitled, My Kingdom for an Intravenous Line. Wayne, 2006) Since Dr. Orlowski brought the use of IO access in pediatrics back into the medical spotlight, the implications for its use within the adult population were soon being addressed. In 2005, the American Heart Association stated in its Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care that â€Å"IO cannulation was appropriate to provide access to the non-collapsible venous plexus found in the bone ma rrow space, thus enabling drug delivery similar to that achieved by central venous access. (American Heart Association) Intravenous access can mean the difference between life and death when dealing with critically ill patients. IV access means that patients can receive fluids, blood products, and life-saving medications. During situations when time is precious, and access is critical is not when nurses should be making their fifth attempt at a peripheral intravenous catherization (PIV). It also shouldn’t be when chest compressions are stopped, so that the doctor can try for a central venous line (CVL). The average time necessary for PIV catherization is reported to add up to 2. 5-13 minutes and sometimes even up to 30 minutes in patients with difficult to access peripheral veins. (Leidel, Chlodwig Bogner, 2009) This is one of many reasons why it is imperative to have a policy in place so that the staff knows that IO access should be a go to option rather than a last resort. There are very few contraindications when it comes to the placement of an IO device. However, to untrained medical personnel the thought of having to place an IO device is very daunting. I didn’t realize until this semester that it is within the scope of practice for a RN to place an IO device, but it is absolutely is! â€Å"It is the position of the Infusion Nurses Society that a qualified RN, who is proficient in infusion therapy and who has been appropriately trained for the procedure, may insert, maintain, and remove intraosseous access devices. † (â€Å"The role of,† 2009) There is also the fact that of having to explain the procedure to the patient and the patient’s family. The fear of needles is a real one. The thought of an intramuscular injection can send certain patients into a full blown panic attack. So the thought of actually having their bone pierced with a needle is a frightening one. Thankfully most patients who are critically ill enough to necessitate the placement of an IO device are unconscious. In cases where patients are not unconscious, an IO device can be placed with minimal discomfort if proper anesthetic techniques are used. These techniques should be taught along with placement so that nursing staff is aware of how to place an IO with minimal discomfort to the patient. It needs to be noted that â€Å"the pain associated with insertion of the EZ-IO needle is similar to that associated with insertion of a large peripheral intravenous needle and may be alleviate with infusion of lidocaine solution. † (Luck, Haines Mull, 2010) Unlike PIVs and CVLs, IO access can be obtained from multiple sites with less chance of being unsuccessful. The locations include: proximal tibia, distal to the tibial tuberosity, distal end of the radial bone in the upper imb, proximal metaphysis of the humerus, distal tibia, proximal to the medial malleolus, distal femur, above the femur plateau, the sternum, and also the calcaneus (Tay Hafeez, 2011). However, IO access is typically obtained via the proximal tibia or proximal metaphysis of the humerus. There are currently three different ways to gain IO access. The first and oldest way is a manual insertion of the IO device. In this way the device is placed using the force applied by the clinician, and is done in a rot ating motion. The second technique is the use of an impact device. In this case, a spring-loaded IO device is to insert the needle into the bone using direct force. The last technique is a powered drill. The small, handheld device drills the IO needle into the bone with a high-speed rotating motion. Plan To implement a policy within the Emergency Department at Hays Medical Center that clearly outlines when the placement of an intraosseous access device should be used as opposed to more traditional techniques for gaining venous access. A committee would be assembled to look at the research on IO placement. This committee would consist of three physicians and three nurses, and will be given three months to write a policy for the department. This committee will determine in which situations an IO should be placed. The American Heart Association guidelines for intraosseous vascular access should play a major role in this decision. Once criteria has been chosen a checklist will be created that can be hung on the walls of the trauma rooms and handed out to staff. This checklist will aide in helping the staff to be able to more quickly determine in which situations placement of an IO is within the department’s policy. The appointed committee would also be in charge of deciding on which type of IO device the department should use. They will research the availability of the device chosen and what the cost will be to stock the department which the device. Do Once the research is gathered, the assigned research committee will reassemble to compose the policy that will become implemented within the Emergency Department. After the policy has been written, a mandatory unit meeting will be called to introduce the new policy and answer any questions that the staff might have. During this meeting, a demonstration will be given on the correct technique for IO placement, depending on which type of device is chosen during the planning phase. After the demonstration the staff will then be asked to practice placing IO devices using practice bones. One member of the department will then be voted upon to keep track of which patients coming through the department have IO devices placed. They will keep track of for the next six months. The data collected will include any outcomes that the patient experiences, good or bad, in regards to their IO placement. Check The member of the department will look at the data collected from the outcomes of patients who had IO devices placed within the ED in the last six months. This data will then be taken back to the originally assigned committee. The committee will be responsible for analyzing the data. They will look at the outcomes and determine if changes need to be made to the original policy. They will also look at the outcomes to determine if there need to be changes made in the placement technique used by the department. For example, is the rate of successful placement higher or lower when done via the humerus verses the tibia? Or is there a problem with post procedural infection? Should the technique be changed from aseptic to sterile? Etc†¦ They will also ask staff within the department to fill out a survey indicating their comfort level in placing IO devices. Act Depending upon the findings of the committee they can either be decided to leave the policy in place, as is. The committee could find that the policy needs to be altered and then reviewed in another six months’ time to see if the changes were effective. Or they could find that within the ED at Hays Medical Center IO devices for venous access should not be used although the review of literature will prove why this outcome is highly unlikely. Research to Support Change An article published in the Journal of Emergency Medicine, collaborated by three different physicians who work in Emergency Departments in Philadelphia talks about the technical side of intraosseous access. The article states that â€Å"intraosseous vascular access is indicated in the critically ill patient of any age when rapid and timely access via the intravascular route cannot be established or has failed. The article goes on to list conditions in which this might occur, including: cardiopulmonary arrest, shock, sepsis, major traumatic injuries, extensive burns or edema, and status epilepticus. (Luck, Haines Mull, 2010) Indications may also include obese patients on who multiple PIV attempts have failed. Because studies have shown that IO infusions have the same o nset of action, as that of intravenous infusions the authors recommend that the dose used for IV fluids and medications should remain unchanged when using the IO route. They go one to state that other studies have shown that the results of several different blood test values drawn from bone marrow aspirates are comparable to those taken from venous samples. These include blood gas analysis, blood group typing, and electrolyte, drug, and hemoglobin levels. (Luck, Haines Mull, 2010) The authors also talk about the relatively few contraindications for IO insertion. These include a fracture to the bone that the IO device is to be placed, an extremity with a vascular injury, placement to an area with an overlying skin infection or burn. IO insertion is also contraindication in patients with certain conditions that make their bones fragile such as osteogenesis imperfect and osteoporosis. The last contraindication is a new IO insertion where another IO needle may have recently been placed. This is because the opening left by the last needle can cause fluids to extravasate. In their research of other studies, the authors found that success rates for IO insertion vary between 75%-100%, and successful infusion achieved within 30-120 seconds in the majority of cases. Luck, Haines Mull, 2010) The most common complication was found to be extravasation of blood, fluids, and drugs into the soft tissues surrounding the site, but this occurred less than 1% of the time. With a 0. 6% chance of incidence, the most serious adverse complication was osteomyelitis. However, this was attributed to prolonged infusion. For this reason, it is recommended that the IO need be replaced by either a PIV or a CVL once the patient has stabilize d and no longer than 24 hours after IO placement. (Luck, Haines Mull, 2010) This article concluded that the use of IO access devices is a safe, reliable, and timely way of attaining vascular access. Although vital for critically ill and injured patients, it is also a technique that can be applied in non-emergent cases where multiple attempts at peripheral and central IV access has been unsuccessful. (Luck, Haines Mull, 2010) In a study conducted by physicians at the University of Medicine Berlin’s Department of Emergency Medicine, they looked at ten consecutive adult patients who each received an IO device and also a CVC placement during a resuscitation situation. The results showed that the success rate on first attempt was 90% for IO access versus 69% for CVC placement. They also found that the mean time required for the IO access procedure was significantly shorter, 1-3 minutes, compared to the mean CVC placement time of 4-17 minutes. While conducting this study, one IO cannulation failed â€Å"due to operator mishandling by not selecting the correct insertion site at the proximal humerus. (Leidel, Chlodwig Bogner, 2009) The physicians of this study also noted that four CVC cannulations failed on the first attempt at insertion and had to be reattempted. The study then went on to state that the failed placement of one IO cannulation was the only complication regarding the IO devices placed. There was â€Å"no malposition, dislodgment, bleeding, compartment syndrome, arterial puncture, haeatothorax, pneumothorax, venous thrombosis, and vascular access related infection observed. † (Leidel, Chlodwig Bogner, 2009) In conclusion the researchers go on to state â€Å"IO vascular access is a safe, reliable, rapid option in the acute setting of adult patients under resuscitation with inaccessible peripheral veins in the emergency department†¦ Therefore, a change in practice from CVC to immediate IO access for the initial emergency resuscitation should be strongly considered as a reasonable bridging technique to increase patient’s safety in the emergency department. † (Leidel, Chlodwig Bogner, 2009) Another study found was performed by physicians and researchers in the Department of Emergency Medicine of Singapore General hospital. It is a large urban hospital that handles nearly 120,000 patients annually. 9% of these patients are priority 1 patients, or patients that need resuscitation. The inclusion criteria for this study were â€Å"patients who presented to the ED with age greater than 16 years or 40kg body weight requiring intravenous fluids or medication and in whom an intravenous line could not be established in two attempts or 90 seconds. They also had to be seriously ill or injured and meet at least one or more of the following: altered mental status, respiratory compromise, haemodynamic instability, or cardiac arrest. (Ngo, Oh, Chen, Yong Yong, 2009) The study ran from March 1, 2006 through July 30, 2007. During this time 24 patients were met the qualifications for this study. Of all the IO cannulations, only three attempts failed on the first attempt. No failures were recorded on the second attempt. The researchers also did a comparison between junior operators and senior operators and found that t here were no disparity regarding success rates between the groups, they both had a 100% success rate. The average insertion time for both groups was approximately five seconds. Ngo, Oh, Chen, Yong Yong, 2009) There were only two complications regarding the insertion of an IO device with this study. The first was when an operator’s glove was caught on the need during insertion. However, this could have been prevented if the operator was holding the drill properly. The other complication noted was that of extravasation of fluid at an insertion site. This is the most common type of complication, and is seen when the need is misplaced or there is an excessive amount of movement during or after the insertion. Ngo, Oh, Chen, Yong Yong, 2009) The results of this study concluded that â€Å"the EZ-Io is a feasible, useful and fast alternative mode of venous access especially in the resuscitation of patients with no venous access or when conventional intravenous access fails. Flow r ates may be improved by the use of pressure bags. Complications encountered such as extravasation of fluid and gloves being caught in the drill device can be easily prevented. † (Ngo, Oh, Chen, Yong Yong, 2009) The third research article was a prospective, observational study conducted by researchers in the Department of Emergency Medicine at Singapore General Hospital in Singapore. The study was conducted on a convenience sample of 25 medical students, physicians and nursing staff. They were recruited to secure intraosseous access using the EZ-IO powered drill device. Unlike the previous two studies they only need to secure access on a plastic bone model rather than a live patient. (Ong, Ngo Wijaya, 2009) The study participants were allowed multiple attempts in placement with the aim of ensuring success in placement. Their placement times were measured by an independent observer with a stopwatch, from the time the participant placed the need set into the driver and attempted to insert the needle with the ES-IO into the plastic bone. The participants then recorded their perception on the difficulty of insertion using a visual analog scale with 0 representing very easy and 10 representing very difficult placement. (Ong, Ngo Wijaya, 2009) The results showed 96% success rate for placement. Twenty-three of the 25 participants only required one attempt at place the IO device, and only one participant was unsuccessful at securing placement of the device. This failure was attributed to â€Å"unfamiliarity with the equipment and procedure, and hesitating beyond the allocated time given for insertion. † (Ong, Ngo Wijaya, 2009) The results of this study also showed that the mean placement time was 13. 9 seconds. The researchers also found that 87% of their participants reported that using the EZ-IO was easier compared to intravenous cannula. Ong, Ngo Wijaya, 2009) The researchers of this study concluded that â€Å"the I/O access device (EZ-IO) evaluated in this study appears to be easy to use with high success rates of insertion with inexperienced participants. There is potential for use in the Emergency Department. (Ong, Ngo Wijaya, 2009) The next piece of research was a randomized trial conducted by Dr. Reades from Methodist Hospital System, in Dallas, TX, Dr. St udnek from Carolinas Medical Center and the Center for Prehospital Medicine, Charlotte, NC, S. Vandeventer from Mecklenburg EMS Agency, Charlotte, NC, and Dr. Garrett from Baylor Healthcare Systems, Department of Emergency Medicine, Baylor University Medical Center, and Dallas, TX. The purpose of this study was to determine whether the tibial or humeral placement site was more effective for intraosseous placement during out-of-hospital cardiac arrest. â€Å"All patients eligible for inclusion in this study had their first attempt at vascular access randomized to one of 3 locations: proximal tibial intraosseous, proximal humeral intraosseous or peripheral intravenous. (Reades, Studnek, Vandeventer Garrett, 2011) Randomized note cards were distributed to the paramedic staff at the beginning of their shifts, and told them which access site was to be initially used if they came had a patient who met the inclusion criteria. There were two outcomes that were being monitored in this study. The first was a first-attempt success at the assigned method of vascular access. This qualifi ed in one of two ways, either as an initial success or an overall success. The second measured outcome was the â€Å"total number of attempts required for successful vascular access, time to successful vascular access, time to first ACLS medication, and total volume of fluid infused during resuscitation. † (Reades, Studnek, Vandeventer Garrett, 2011) Overall there were 182 patients randomized to one of the 3 vascular access methods. Fifty-one patients had humeral IO placements, 67 had PIV placements, and 64 had tibial IO placements. The results showed that first-attempt success was greatest in patients randomized to tibial IO access at 91%, compared to both humeral IO access at 51% and PIV access at 43%. The result of the secondary outcome was also significantly shorter in patients with tibial IO access. These patients had their devices in place and ready to use in an average of 4. 6 minutes. Those assigned to the humeral IO access site averaged a 7. 0 minute placement time, which was also the same time for a PIV access site. (Reades, Studnek, Vandeventer Garrett, 2011) This study demonstrated that there is a significant different in the frequency of first-attempt success when placing tibial IO access devices as opposed to humeral IO access devices or even PIV catheters. The researchers go on to state that the â€Å"results from this study may help stakeholders such as EMS medical directors choose the most appropriate site for first-attempt vascular access†¦Ã¢â‚¬  (Reades, Studnek, Vandeventer Garrett, 2011) The last article was a consortium on intraosseous vascular access in healthcare practice, published in a journal entitled critical care nurse. It too outlined the history of IO access, dating back to World War II. It discussed the clinical considerations for the use of IO access, and the clinical situations in which IO access should be considered. It went on to talk about the types of IO devices and how they’re used. It mentioned the contraindications for IO use, and also the possible complications. All of the aforementioned material was consistent with research already discussed. This article lends credibility in support of change because it discusses the education and training needed to implement IO device use in the clinical setting. It states that â€Å"to insert and maintain an intraosseous device in a patient, the clinician must demonstrate adequate knowledge and psychomotor skill competency in the procedure. (Phillips, Brown, Campbell, Miller, Proehl Young-berg, 2010) The article then went on to discuss the economic considerations that must be looked at when considering implementing an IO insertion policy. It states that â€Å"the cost of intraosseous devices and needles should be compared with the cost of central catheter kits, ultrasound evaluation, and human resources required for their insertion. † ( Phillips, Brown, Campbell, Miller, Proehl Young-berg, 2010) The authors also note that â€Å"the economic factors must be weighed along with potential complications of therapeutic strategies should be considered. (Phillips, Brown, Campbell, Miller, Proehl Young-berg, 2010) This article also brings to light the issue of risk management and patient safety. In this day and age where liability concerns continue to drive clinical decisions, it is important to note that delays in treatments are often cited as the cause of injury leading to malpractice claims. If there is an evidenced based option to safely and quickly provide fluid and drug resuscitation, when vascular access is not readily attainable, then it needs to be closely looked at. After reviewing the data the Consortium on Intraosseous Vascular Access in Healthcare Practice reached eight consensuses: 1. Intraosseous vascular access should be considered as an alternative to peripheral or central intravenous access in a variety of health care settings, including intensive care units, high acuity/progressive care units, general medical units, preprocedure surgical settings where lack of vascular access can delay surgery, and chronic care and long-term care settings, when an increase in patient morbidity or mortality is possible. . Intraosseous vascular access should be considered as part of an algorithm for patients treated by rapid response teams in whom vascular access is difficult or delayed. 3. A new algorithm that includes the intraosseous route should be developed for assessing the appropriate route of vascular access. 4. For patients not requiring placement of central catheters either for long-term vascular access or hemodynamic monitoring, intraosseous ac cess should be considered as the first alternative to failed peripheral intravenous access. 5. Techniques of intraosseous catheter placement and infusion administration should be a standard part of the medical school and nursing school curriculum. 6. In evaluating the economic implications of adopting intraosseous technology, the following should be considered: the expense of diagnostic tools to guide and confirm placement, the cost of human resources, the known and unknown risks to patient safety, and the cost of complications related to delayed treatment. 7. Organizational policies, procedures, and protocols that establish the responsibility of insertion, maintenance, and removal of intra-osseous access devices should be developed. . Further research should be conducted on, but not limited to, the safety and efficacy of use of intraosseous access in all practice settings, its economic impact on patient care, and to support the use of intraosseous access in all health care settings. Change Theory The change theory focused upon in this paper is Gordon Lippitt’s Theory o f Planned changed. According Lippitt, â€Å"Planned change or ‘neomobilistic’ change is defined as a conscious, planned effort which moves a system, an organization, or an individual in a new direction. This theory is applies because it can be applied at an individual, group, and institutional level. The basis for Lippitt’s theory of change is center around an agent for change. This agent should be a person skilled in the changed wanted to apply. It is this person who is in charge of planning for the change, initiates the change, and is credited for the accomplishment of change. Lippitt’s theory is centered around 7 phases of change. His phases are not set in stone, and there is no time frame on how long each phase should last. There should be a fluid movement back and forth between these seven phases. The first step is identification and diagnosis of the problem. In this case, the problem is HMC not having a firm policy in place recommending when the use of IO access devices should be implemented. The second step is the change agent assessing the client systems motivation and capacity for change. In this case, myself being the change agent, I would talk with the administrators of the ED department and determine if they agreed with my assessment for a policy to be implemented. The third step would be the initiator assesses his or her ability in helping the situation. In this case this flows back to the first step, because I saw the need for change and felt that I was equipped with the skills needed to bring about such a change. The fourth step is the change agent then chooses an appropriate role in the phase. In this case, I would choose to be part of the policy committee who is responsible for researching. The fifth step states that the change agent may be actively involved in the implementation of change, serve as an expert in fathering and providing data, or function as a liaison within the organization. I feel like in this case, I would function as a liaison within the policy making committee. The sixth step consists of maintenance of change. This involved the â€Å"Do† portion of the plan for change. This is where the decisions made by the policy are provided to the department, and the employees become responsible for implementing and maintaining the new policy. The final step is termination of the helping relationship. This step is accomplished when all parts of the PDCA plan have been completed. (Ziegler, 2005) Conclusion In a day and age where medical technology is advancing, the research about IO access devices proves that newer technologies are not always the best for a positive outcome. IO access applications have great potential in patients who are critically ill, injured, or are incapable of having PIV or CVL access. The fact that IO access is fast, reliable, and safe proves that competent placement of IO devices is a medical technique that all Emergency Departments should have in their repertoire. References (2009). The role of the registered nurse in the insertion of intraosseous access devices. Journal of infusion nursing,  32(4), 187-188. American Heart Association. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005;112(24):57-66. Leidel, B. Chlodwig, K. , Bogner, V. (2009). Is the intraosseous access route fast and efficacious compared to conventional central venous catherization in adult patients under resuscitation in the emergency department? a prospective observational pilot study. Patient safety in surgery,  3(24), doi: 10. 1186/1754-9493-3-24 Luck, R. , Haines, C. , Mul l, C. (2010). Intraosseous access. The journal of emergency medicine,  39(4), 468-475. Ngo, A. , Oh, J. , Chen, Y. , Yong, D. , Yong, D. (2009). Intraosseous vascular access in adults using the ez-io in an emergency department. International journal of emergency medicine,2(3), 155-160. oi: 10. 1007/s12245-009-0116-9 Ong, M. , Ngo, A. , Wijaya, R. (2009). An observational, prospective study to determine the ease of vascular access in adults using a novel intraosseous access device. Annals of the academy of medicine, singapore,  38(2), 121-124. Phillips, L. , Brown, L. , Campbell, T. , Miller, J. , Proehl, J. , Young-berg, B. (2010). Recommendations for the use of intraosseous vascular access for emergent and no emergent situations in various health care settings: A consensus paper. Critical Care Nurse,  30(6), e1-e7. Reades, R. , Studnek, J. , Vandeventer, S. , Garrett, J. (2011). Intraosseous versus intravenous vascular access during out-of-hospital cardiac arrest: A randomized controlled trial. Annals of Emergency Medicine,  58(6), 509-516. Tay, E. T. , Hafeez, W. (2011). Intraosseous access. In R. Kulkarni (Ed. ),  Medscape reference: Drugs, disease procedures. Retrieved from http://emedicine. medscape. com/article/80431-overview Wayne, M. (2006). Adult intraosseous access: an idea whose time has come. Israeli journal of emergency medicine,  6(2), 41-45. Ziegler, S. (2005). Theory-directed nursing practice. (2 ed. , p. 204). New York, NY: Springer Publishing Company, Inc. Timeline for Change 1/20-11/27Researched the benefits of having a policy about intraosseous access within the ED at HMC 11/28Spoke with the Director of Nursing for the ED and the Director of Emergency Medicine about my research findings 12/1A committee of three physicians and three nurses is assembled to draft a preliminary policy regarding intraosseous access 12/1-3/1The committee is given three months to compose their policy 3/2-3/10The policy is given to the Director of Nursing and Director of Emergency Medicine, who present it to the board of directors for approval 3/15A mandatory staff meeting is held outlining the new policy and answering any questions or concerns the staff has 3/16-9/16The new policy is put into effect and data is collected 9/16-10/16The original committee will analyze the data, and changes are made as needed. 10/20The final committee approved policy is present to the Director of Nursing and Director of Emergency Medicine 11/1The Director of Nursing and Director of Emergency Medicine, take the final recommendations for the policy to the hospital board of directors for approval How to cite The Use of Intraosseous Vascular Access, Essay examples

Model Answer free essay sample

Sample exam question and model response p. 19, from â€Å"And the Baths †¦Ã¢â‚¬  to â€Å"the water is absolutely dangerous to use, either internally or externally. † Question: How does Ibsen portray the Baths is this extract, and for what purposes? This extract occurs in Act I, during a conversation between Doctor, Petra and Mrs Stockmann with Hovstad, Horster and Billing. The subject of the conversation is the town Baths, and their poisoning by effluent from Morten Kiil’s tannery at Molledal. This discussion foreshadows the action in the remainder of the play, where Dr Stockmann discovers that the corruption of the waters feeding the Baths is also in the minds of the townspeople who oppose the closure of â€Å"the town’s life-blood†. The fact Stockmann and Billing refer to the Baths as the â€Å"main artery of the town’s life-blood†, â€Å"the nerve centre of the town† and â€Å"the town’s pulsating heart† metaphorically links the Baths to vital organs in the human body, an appropriate image for a doctor whose job it is to assist the health of individuals in any community. We will write a custom essay sample on Model Answer or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Of course, this metaphor on one level simply means the town is very dependent on the Baths for its material prosperity. On another level, however, it connects with imagery throughout the play of moral health and corruption, whereby the Baths become a symbol of what taints the community – that is, their leadership’s dishonesty in dealing straightforwardly with Dr Stockmann’s scientific evidence that the Baths are in fact contaminated, and the people’s materialistic fears for the loss of their livelihoods. Ibsen, by linking the Baths to the body, links them to health and illness, so they reflect the moral as well as physical wellbeing of the town.

Free Essays on Typwriters

Typewriter patents date back to 1713, and the first typewriter proven to have worked was built by Pellegrino Turri in 1808 for his blind friend Countess Carolina Fantoni da Fivizzono. Commercial production, however, began only with the â€Å"writing ball† of Danish pastor Malling Hansen (1870). This device looked rather like a pincushin. Nietzsche’s mother and sister once gave him one for Christmas. He hated it. More significant is the sholes and &Glidden Type Writer, which began production in late 1873an appeared on the American market in 1874: Christopher L. Sholes, a Milwaukee newspaperman, poet, and part-time inventor, was the main creator of this machine. The Sholes & Glidden typed only in capitol letters, and it introduced the QWERTY keyboard, which is very much with us today. The keyboard was probably designed to separate frequently- used pairs of typebars sop that the typebars would not clash and get stuck at the printing point. The S&G was a decorative machine, boasting painted flowers and decals .I looked rather like a sewing machine, as it was manufactured by the sewing machine department of the Remington arms company. For an in-depth look at this historic device , visit Darryl Rehr’s Web site â€Å" The First Typewriter.† The Sholes & Glidden had limited success, but its successor, the Remington, soon became a dominant presence in the industry. The Sholes & Glidden, like many early typewriters, is an understroke or â€Å"blind† writer: the typebars are arranged in a circular basket under the platen(the printing surface) and type on the bottem of the platen. This means that the typist( confusingly called a â€Å"typewriter† herself in the early days) has to lift up the carrige to see her work. Another example of a understroke typebar machine is the caligraph of the 1880,the second typewriter to appear on the American market. This Caligraph #3 has a â€Å"full† keyboard- separate keys for lower- and upper-case l... Free Essays on Typwriters Free Essays on Typwriters Typewriter patents date back to 1713, and the first typewriter proven to have worked was built by Pellegrino Turri in 1808 for his blind friend Countess Carolina Fantoni da Fivizzono. Commercial production, however, began only with the â€Å"writing ball† of Danish pastor Malling Hansen (1870). This device looked rather like a pincushin. Nietzsche’s mother and sister once gave him one for Christmas. He hated it. More significant is the sholes and &Glidden Type Writer, which began production in late 1873an appeared on the American market in 1874: Christopher L. Sholes, a Milwaukee newspaperman, poet, and part-time inventor, was the main creator of this machine. The Sholes & Glidden typed only in capitol letters, and it introduced the QWERTY keyboard, which is very much with us today. The keyboard was probably designed to separate frequently- used pairs of typebars sop that the typebars would not clash and get stuck at the printing point. The S&G was a decorative machine, boasting painted flowers and decals .I looked rather like a sewing machine, as it was manufactured by the sewing machine department of the Remington arms company. For an in-depth look at this historic device , visit Darryl Rehr’s Web site â€Å" The First Typewriter.† The Sholes & Glidden had limited success, but its successor, the Remington, soon became a dominant presence in the industry. The Sholes & Glidden, like many early typewriters, is an understroke or â€Å"blind† writer: the typebars are arranged in a circular basket under the platen(the printing surface) and type on the bottem of the platen. This means that the typist( confusingly called a â€Å"typewriter† herself in the early days) has to lift up the carrige to see her work. Another example of a understroke typebar machine is the caligraph of the 1880,the second typewriter to appear on the American market. This Caligraph #3 has a â€Å"full† keyboard- separate keys for lower- and upper-case l...

Heres Every College That Offers 100% Financial Aid

Here's Every College That Offers 100% Financial Aid SAT / ACT Prep Online Guides and Tips One of the most important questions you will have to ask yourself during your college selection process is whether or not your top choice school is affordable for your family. Affordability has a huge impact on college decisions. Some students will luck out and be offered a nice scholarship by their school that will make things affordable. Others will win independent scholarships. Usually, though, both of these options for financing your education are based on merit, and there is a lot of competition. But did you know that some schools are committed to making sure all admitted students can afford to attend, regardless of whether they are scholarship recipients? Read on to see a list of colleges that meet full need, or provide for 100% of their students’ demonstrated financial need. What Does Demonstrated Financial Need Mean? Part of the application process is filling out a multitude of forms that colleges use to determine how much your family can reasonably afford to pay. The two most common forms are the FAFSA (short for the Free Application for Federal Student Aid) and the CSS Profile (short for the College Scholarship Service Profile). Other schools may have their own forms that they ask you to fill out. On these forms, you’ll have to state your parents’ income and assets, as well as your own (if you have any), and the number of dependents in your household. The government and colleges then run some calculations to decide what’s reasonable for your family to contribute to the cost of your education. Of course, this plan is not foolproof for getting the money you need for college. First of all, many families feel that the government and colleges do not do a very good job of determining how much they are able to pay. The calculations can be different from school to school, and just because an outside arbiter has decided that your family can â€Å"afford,† say, $15,000 per year, doesn’t mean that in reality they can. Many families feel they are in a difficult situation because their incomes are too high for the larger pools of financial aid but too low to be comfortable giving up such a large chunk of money. Of course, the situation is even worse for those who are planning on sending multiple kids to college. Additionally, just because you demonstrate financial need doesn't mean that you will get financial aid- or at least, as much as you need. Many schools simply cannot afford to give away as much financial aid as their students need. They instead give some money, but not enough to cover the cost. For example, let’s say your school costs $54,000 per year. You've been told that your family can afford to pay $20,000 per year- but in reality, that’s a stretch. That leaves you $34,000 short of full tuition. Your school offers to kick in $15,000. So you are left with a gap of $19,000, plus the $20,000 that you couldn’t really afford in the first place. This is why so many students are left with no option but to take out extensive private student loans, often leaving them riddled with massive debt for years after graduation. 100% Meet Need Schools Fortunately, there are some schools out there that are committed to staying affordable for all of their students. Colleges and universities that pledge to meet 100% of their students’ financial need are a relatively rare breed. There are currently fewer than 75 schools that will meet all of your financial need. The schools on the lists below make sure that you get the money you need (outside of your family’s calculated contribution, of course) through grants, loans, work study, and scholarships. Some have taken this generosity one step further and pledged that they will meet the full financial need of their students without requiring them to take out loans. What Does This Financial Aid Look Like? For the top schools listed below, financial aid will come 100% in the form of grants, scholarships, and work study. Grants and scholarships are financial gifts that do not need to be paid back. Work study means that these schools guarantee you will be given a job that will cover some of your costs. However, some of the schools listed below will also include loans as part of their financial aid packages. When a school considers your FAFSA and your aid package, they also determine your eligibility for federal loan programs. These loans need to be repaid, but if they are granted through your school, they count as part of your â€Å"100% financial aid program.† The most common federal loans that you will hear about being part of your financial aid package are as follows: Subsidized Stafford Loans: the government pays interest while you are in school and during your grace periods Unsubsidized Stafford Loans:you are responsible for the interest that accrues while you are studying Federal PLUS Loans:given to theparents of undergraduate students These loans are usually much better than private student loans because they tend to have lower interest rates, grace periods, convenient repayment plans, and loan forgiveness programs. However, there are limits to the amount that a student can borrow every year through federal loan programs. Therefore, some students will additionally be offered loans through their school. Though the rates on these loans are not usually quite as low-interest as federal loans, they tend to have lower interest rates than other private loans. The other big difference between schools that include loans as part of their 100% need-met financial aid programs and schools that leave a portion of your needs unmet and require you to find your own loans is that you qualify automatically for these loans if they are offered as part of your financial aid package. Receiving the loans is as easy as checking a box on your financial aid statement. What Kinds of Schools Meet 100% of Need? As you are looking over the lists below, you might start to notice a pattern.Most of these schools are well known for being excellent in their fields.It’s usually the top schools that are committed to and able to meet 100% of their students’ financial needs. There are a few reasons for this. The first is that, traditionally, these schools are attended by wealthier students. When many students are paying full price, and some even have family members making financial donations to the school, these schools will have more money to spread around to students who are not as well-off financially. Many of these schools also have larger endowments than the average university, which means there is more money to give to students who need it. Finally, meeting 100% of students’ financial needs has become a selling point for top schools that are competing for top students. Once one school started having this policy, others had to match it to stay competitive and continue being attractive to the best students. The bottom line is that you can attend a top school and have it be affordable. The Best of the Best: 100% Need Met Without Loans, Regardless of Income The following schools have the most generous financial aid packets. They are willing to meet 100% of your demonstrated financial need without making you take out loans, regardless of your family income. To illustrate what this means, let’s imagine two students going through a fictional financial aid process. Student A’s parents make $130,000 per year but have a couple of children currently attending college. After looking at their FAFSA, the schools below decide Student A’s parents can make a contribution of $30,000 per year toward average yearly fees of $50,000.Student A would, therefore, get the remaining $20,000 per year in financial aid through scholarships, grants, and work study. Student B’s parents, on the other hand, make just under $50,000 per year. After looking at their FAFSA, the schools below decide Student B’s family should not have to contribute financially. Student B is awarded the full $50,000 through scholarships, grants, and work study. All information below is taken from US News. Now, let's look at these crà ¨me de la crà ¨me schools: Harvard has one of the best financial aid programs out there. Amherst College Bowdoin College Brown University Colby College Columbia University Davidson College Harvard University Massachusetts Institute of Technology Northwestern University Pomona College Princeton University Stanford University Swarthmore College University of Chicago University of Pennsylvania US Air Force Academy US Naval Academy Vanderbilt University Washington and Lee University West Point Yale University Second Best: 100% of Need Met With No Loans for Some Incomes These schools will meet 100% of your financial need no matter what your family’s income is, but if your income is below a certain level, they will also make sure you don't have to take out any loans. Let’s consider Student A and Student B again to illustrate this. Student A’s parents can contribute $30,000 per year toward the $50,000 cost of tuition and living. To meet the $20,000 of need, Student A is offered $3,500 in Subsidized Stafford Loans and $2,000 in Unsubsidized Loans, while theparents are offered a PLUS Loan of $2,500. Student A is then offered the final $12,000 through a combination of scholarships, grants, and work study. Student B’s parents make less than $50,000. Almost all of the schools listed below require no financial contribution from Student B’s parents. Student B is offered the full $50,000 yearly cost through scholarships, grants, and work study. The following schools are taken from US News. Below are the schools that offer this kind of aid: Dartmouth is one of the schools that offers loan-free aid to some students. Cornell University Aid is loan-free if your parents' total income is less than $60,000 and total assets are less than $100,000. Dartmouth College Aid is loan-free if your parents earn less than $100,000. Your family will not be expected to make any financial contribution. Duke University Aid is loan-free if your parents earn less than $40,000. Your family will not be expected to make any financial contribution. Haverford College Aid is loan-free if your parents earn less than $60,000. Families making more than this threshold can expect small loans ranging from $1,500 to $3,000 a year. Rice University Aid is loan-free if your parents earn less than $130,000. Vassar College Aid is loan-free for students from "low-income families." Washington University in St. Louis Aid is loan-free if your parents earn less than $75,000. Wellesley College Aid is loan-free if your calculated family contribution is less than $7,000 and your parents earn less than $60,000. All other students qualifying for financial aid can expect to have a maximum of $15,200 in loans over four years. Williams College Aid is loan-free if parents earn less than $75,000 with "typical assets." 100% of Need With Loans Though these financial aid packets won’t seem as great compared with the non-loan ones above, the fact that these schools commit to meeting 100% of students’ demonstrated financial need is a rare thing. These schools expect students to take out some loans as part of their financial aid packagesbut will make sure that there are no gaps between what the aid package is worth and the cost of tuition. Let’s go back to our fictional students for a moment. Student A’s parents who earn $130,000 are expected to contribute $30,000 per year toward the $50,000 cost of attendance. Student A is awarded $3,500 in Subsidized Stafford Loans, $2,000 in Unsubsidized Stafford Loans, and a $3,500 loan directly from the school. Student A’s parents are also offered a $7,000 PLUS Loan. Finally, student A gets the opportunity to earn $2,000 per year in work studyand receives a grant for $2,000. By contrast, student B’s parents make less than $50,000 and are not expected to contribute anything up front. Student B is awarded $3,500 in Subsidized Stafford Loans, $2,000 in Unsubsidized Stafford Loans, and a $10,000 loan directly from the school. Student B is also offered $3,500 in work study. Student B’s parents get a PLUS loan of $10,000. The final $21,000 is awarded through grants and scholarships. Schools who offer students 100% needs met (with loans) financial aid include the following: USC is one school that meets 100% of financial need with loans. Barnard CollegeBates College Boston College Bryn Mawr College California Institute of Technology Carleton CollegeCase Western Reserve UniversityClaremont-McKenna College Colgate University College of the Holy Cross Connecticut College Colorado CollegeDenison CollegeEmory University (US only) Franklin Marshall College Georgetown University Grinnell College Hamilton College Harvey Mudd CollegeJohns Hopkins University Kenyon College Lafayette College Macalester College Middlebury College Mount Holyoke CollegeNortheastern University (US only) Oberlin College Occidental College Pitzer College Scripps CollegeSkidmore College Smith College Thomas Aquinas College Trinity College Tufts UniversityUCLA Union College University of North Carolina - Chapel Hill University of Notre Dame University of RichmondUniversity of Rochester (does not include Eastman School of Music) University of Southern CaliforniaUniversity of Virginia Wake Forest University Wesleyan University Final Thoughts: Colleges Offering 100% Aid The biggest thing that you can take away from this list is the knowledge that top colleges in the US are working hard to be affordable to all students. If you decide to apply to one of the schools listed above, you can do so with the confidence that you will neither have to come up with the money to finance it up front nor hunt down your own private student loans. And if you don’t see your top choice on this list, don’t be discouraged. More and more schools are working toward being able to cover 100% of their students’ financial needs. Many of the schools that aren’t there yet still have great financial aid packages. Even better, many of them offer merit-based scholarships that you might be eligible for. Also, keep in mind that you should always be on the lookout for outside, private scholarships to help fund your tuition. What's Next? The government can sometimes help with tuition costs, especially if you're from a low-income family. Check out our article to see whether you are eligible for a Pell Grant. As you consider where to apply to college, you might want to look at our list of cheap out-of-state colleges and the most expensive colleges in the country. Don’t be surprised by the surprise costs of college! Read this article to see what college really costs. Want to improve your SAT score by 160 points or your ACT score by 4 points?We've written a guide for each test about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now:

Evaluate the effect of the technological change on the business Essay

Evaluate the effect of the technological change on the business environment of ''TOYOTA IN THE EU'' - Essay Example Notably, technological environment is interlinked with other attributes of an economic environment, such as regulatory policies, GDP growth rate and demand of national as well as international market. These components have been recognised to be changing in the European economic environment. For instance, technological environment of the European Union (EU) has been noticed to favour nanotechnology and communication technology rather than other technological innovations. Consequently, this shall have a great impact on the performance of businesses which are entirely based on the technological environment, e.g. Toyota. With this concern, objectives of the paper shall be to assess various changes occurring in technological environment of the EU economy and its impact on the performance and/or organisational operations of Toyota in EU. The discussion of the paper will be thereby focussed on identifying opportunities and challenges which are likely to be witnessed by the company due to th e technological change in its business environment. Subsequently, the paper shall also intend to recommend few significant measures for the company. 2.0. Changes in Technological Environment of EU In modern day perspective, economic environment and its components possess a crucial role in influencing the growth of an economy. Few major components of economical environment of an economy are its political, economical, social and technological environment. Most economies, along with the EU have become largely depended on its technological growth which defines environmental aspect as one of the most crucial phenomenon of 21st century. Evidences reveal that technological environment of the EU is changing rapidly with a strong influence on social and economical environment at large. For instance, the member countries which are part of the European Union, such as Denmark, Germany and Poland are recognised to be largely depended on coal industry. Consequently, these economies release higher amount of greenhouse gases and generate larger amount of heat than other economies in the union. On the contrary, technological trends of the union are recognised to be focussed on NBIC technology, i.e. biotechnology, nanotechnology, information and communication technology and cognitive science. This forced the countries to set up end-of-pipe technologies, which in turn shall reduce hazardous impact of technological development on natural environment of the union (Eurostat, 2010). Another major trend of the technological environment of the European Union was the enforcement of tax on NOx in Sweden and similar taxation policies on technological practices which are harmful for environment in other countries. Remarkably, almost 7% of technology based firms of Sweden initiated to imply the available ‘abatement technologies’ in 1992 and one year later, number of firms using these technologies increased to 62%. Thus, the taxation policies also had a great influence on busin ess sector of the economy (OECD, 2010). With a growing concern of eco-friendly technology, regulatory framework of the union is also promoting eco-technology and innovations. Due to this fact, most technology based companies are tending to incorporate renewable technologies in their organisational operations. Governing bodies of the union also enforced