Preventive Measures of Hepatitis A

Preventive Measures of Hepatitis A

 

Hepatitis A is a liver infection effected by the hepatitis A virus (HAV) whose

symptoms include fever, fatigue, appetite loss, nausea, abdominal discomfort,

dark urine and jaundice. The infection commonly lasts less than 2 months, although

one can be ill for up to 6 months. Chronic liver disease patients are recommended

for vaccination for protection against serious complications.[1]

 

Hepatitis A can be obtained by ingesting food or water that has fecal material

exposure from an infected individual, with most infections arising from contact with

family members or sexual partners. The virus can survive on outside the body surfaces

and infection occurs when there is poor hygienic behavior.  The infection is most

common in developing countries and in communities that have unsanitary conditions

and do not have a source of clean drinking water.[2]

 

Hepatitis A can be totally prevented by always observing basic hygiene. Everyone must

wash his/her hands with soap and water before preparing or handling food and after

using the bathroom and changing a diaper. Food handlers must not be ill and should

always wear gloves when preparing ready-to-eat foods.[3]

 

Routine hepatitis A vaccination has been recommended for children ages 12-23

months and for integration into the routine vaccination schedule of children. The

vaccine may also offer protection to the household contacts of infected persons.

Individuals traveling to high-risk areas who have not been vaccinated should receive

a single dose of Immune Globulin, which can protect against hepatitis A infection for

a period of three months.[4]

 

Immune globulin (IG), when administered within 2 weeks of last exposure to infection,

 is 80 to 90 percent effective in preventing clinical hepatitis A. It is most effective when

when administered early in the incubation period and is weaker when given later in

 the incubation period. If medically recommended, Hepatitis A vaccine could be

administered at the same time.[5]

 

The following individuals are recommended for hepatitis A vaccination:[6]

Travelers to high-risk for hepatitis A areas

Men who have men as sexual partners

Drug users who inject and do not inject

Blood clotting-disorder patients

Chronic liver disease patients

Health or laboratory workers with risks of infection

Children living in high-risk for hepatitis A areas

Individuals in close contact with persons who have just arrived from high-risk  for

hepatitis A areas

 

Both of the marketed two single-antigen hepatitis A vaccines as of 2010 are not

approved for children less than two years old and must be administered in 2 doses, 6

months in between, for full protection.[7]

 

Eating reminders for preventing hepatitis A include the following:[8]

Only freshly cooked foods should be eaten.

In places where the safety of drinking water is doubtful, only boiled water or

commercially bottled water should be drank.

Drinks with ice in them should not be drank.

Raw fruits or vegetables that are not peeled should only be eaten after thorough

cleaning.

Popsicles and flavored ices that may have been prepared with contaminated water

should be avoided.[9]

Street foods and beverages should be avoided.[10]

 

[1] “Hepatitis A – What It Is, Where It Lives”, Health Search Online, 2011

<http://www.healthsearchonline.com/hepatitis-a-what-it-is-where-it-lives/>

[accessed 21 April 2011]

[2] ibid

[3] “How To Prevent Hepatitis A Infection”, MarlerClark, 2005-2011,

<http://www.about-hepatitis.com/hepatitis_prevention> [accessed 21 April 2011]

[4] ibid

[5] ibid

[6] ibid

[7] Doug Campos-Outcalt, “Hepatitis A: matching preventive resources to needs”,

The CBS Interactive Business Network, 2010, <http://findarticles.com/p/articles/mi_m0689/is_4_53/ai_n6011917/> [accessed 21 April 2011]

[8] “Health Encyclopedia – Diseases and Conditions”, USATODAY.COM, 2001-2011,

<http://www.healthscout.com/ency/68/768/main.html> [accessed 21 April 2011]

[9] “Hepatitis A”, Guide to Surveillance, Reporting and Control, Massachusetts Department of Public

Health, Bureau of Communicable Disease Control, June 2006,

<http://www.mass.gov/Eeohhs2/docs/dph/disease_reporting/guide/hepatitis_a.pdf>

[accessed 21 April 2011]

 

[10] ibid

Human Resource Recruitment and Selection

Human Resource Recruitment and Selection

 

Definition

Objective of a Well Organized Selection Program

Reasons for Proper Selection of Employees

Responsibility for Recruitment, Selection, and Hiring of Employees

Procedures in Recruitment, Selection and Hiring

Human Resource Recruitment Requisition Form

Posting and/ or Advertising Job Vacancies

I. Sources of People

Reception of Applicants

II. Types of Interview

Preliminary Interview

Employment Test

Interview of Human Resource Manager

Investigation of the Job Applicants Background

Supervisor Interviews f or the Best Qualified Applicants

Placement of New Employee

Types of Employee

Regular employee

Temporary employee

Probationary employee

Contractual employee

Casual or seasonal employee

     

Interview Guidelines

 

 

 

_______________________________________________________________________

 

 

Human Resource Recruitment, Selection and Placement

 

I.                   Definition1

 

Recruitment – refers to the practices of organization to persuade people to apply for employment in the company.

 

Selection – the process of determining who from among the job applicants should get the job.

 

Placement – is the function of making a new employee familiar with his new job and work environment.

 

Labor Code of the Philippines

Definition of Recruitment and Placement2

 

            Recruitment and placement refers to any act of canvassing, enlisting, contracting, transporting, utilizing, hiring or procuring workers, and includes referrals, contract services, promising or advertising for employment, locally or abroad, whether for profit or not: Provided, That any person or entity which, in any manner, offers or promises for a fee employment to two or more persons shall be deemed engaged in recruitment and placement.

 

Studying the Different Jobs in the company and writing the Job Description and Specification. 1

 

Job description – Tells what is done on the job, how it is done, why it is done, the skills involved, and the tools and equipment used in doing it.            

 

Job specification – In analyzing the job, it is likewise necessary to know the specific qualifications required of the man who is to do it, such as the following; amount and type of experience needed to perform the job, special training, skills and physical demands, special abilities and aptitudes, age, physical qualifications, and other requirements.

 

II.                Objective of Well Organized Selection Program 3

 

The main objective of good employee selection is to acquire people who possess the ability and competence to accomplish successfully the duties and responsibilities not only of the job to be filled but also of the potential to grow with the company.

 

            If a person is assigned to a job to which his ability, character, and temperament are not suited, he is likely to fail and thereby create a problem for management. It is therefore good personnel policy to attract and hire for every vacant position those who possess the ability, personality and potential to grow with the company and develop them into efficient, loyal and satisfied employee.

 

III.             Reason for proper selection of employees3

 

There are several reason why employees be well selected; some of them are:

 

1.      Company objective are better achieved by workers who have been properly selected.

2.      An incompetent worker is a liability to the company.

3.      Personnel requirements vary from job to job

4.      People have varying degree of intelligence, aptitudes, and abilities

5.      Labor laws protect employees, making it difficult to fire incompetent and problem employees.

6.      Individuals have different interests, goals, and objectives in life.

7.      Careless hiring is costly and can cause problems to the company, especially to the supervisors and managers who have to deal with the workers.

 

IV.             Procedures in Recruitment, Selection and Hiring1

 

            1. Human Resource Recruitment Requisition Form

 

                        To inform the employment office about the existence of a vacancy to be filled, the department head concerned should accomplish a formal requisition form. Indicating the fact and information about the vacancy filled:

Ø  Position or Job Title

Ø  Date when the new employee will be needed

Ø  His rate of pay

Ø  The required qualification of the employee

Ø  The job description and specification

Ø  Approval by the responsible official of the firm and other data

 

Time for selection – In making selection, the employment officer must be given sufficient time to recruit and evaluate records of applicants and to arrive at a sound decision as to the right man for vacancy.

 

            2. Posting and/ or Advertising Job Vacancies

                       

            The purpose is to communicate to employees that they have priority over outsiders as far as opportunities for advancement within the organization is concerned provided they possess the needed qualifications.

 

Sources Of People

a. Inside Sources        

Ø  Job Posting and Bidding

                        b. Outside Sources

Ø  Public Employment Agencies

Ø  Private Employment Agencies

Ø  School and Colleges

Ø  Advertising

 

            3. Reception of Job Applicants

 

            To make the selection truly discriminating there must be several qualified applicants from whom final choice can be made. The chance of finding the individual most qualified for the jobs can be better achieved if there are several applicants to select from.

 

4. Preliminary Interview

           

            The interviewer checks if the job applicant has accomplished either the Employee Information Sheet or Application Form. Using this as a basis, the interviewer then would ask the job applicant certain questions to check, clarify, or communicate information to the job applicant. Then, information about the company like its organizational goal and philosophies, people behind the organization, company history and products, environment for work, opportunities for growth with the organization are discussed.

 

            Types of Interview

 

a. Directive Interview – The directive interview ask for specific information. The questions give more emphasis on the habits and character traits of the person.

 

b.   Non Directive – Non-directive questions are broad, open-ended and require a narrative answer. They permit the applicant to narrate his experiences and to express his interests with minimum guidance from the interviewer.

 

c.    Group Interview – This interview is conducted by panel or committee of three or five interviewers sitting as a panel. The manager of the department concerned is usually a member of the group of interviewer.

           

5. Employment Test

           

            Employment tests are given to job applicants to evaluate characteristics that can not be measured using references, application forms, or interviews. The test to give job applicants should be those that work or is relevant to the position. Employment tests based on personal characteristics intended to be evaluated can be classified into: intelligence, aptitudes, interest, personality, and achievement or proficiency.

 

 

 

 

6. Interview with Human Resource Manager

           

            The Human Resource Manager will evaluate the qualifications of the job applicant. The Human Resource Manager will send only a predetermined number of the best qualified job applicant for a given position or job to the line manager where the vacancy exists.

 

7. Line Manager or Supervisor Interview the Best Qualified Applicants

 

            Depending upon the practice of the organization, the predetermined number of qualified job applicants for a given position is sent for an interview with the line manager or line supervisor where the vacant position is located.

           

            After all the best qualified applicants would have been interviewed by the line manager or supervisor, a list of preference ranking the order of choices of the line manger is sent to the Human Resource Manager.

 

8. Pre-employment Medical Examination

           

            Requiring Medical Examination as a condition for employment serves the interests of both the organization and the employee. On the part of organization, it is a device to ascertain that only medically and physically fir people are employed.

 

9. Placement of the New Employee

 

As soon as the results of the medical examination is received by the Human Resource Manager/ Department, the qualified applicant is given the good news that he or she is now a part of the organization. The final step in the recruitment and selection procedure is in order.

 

V.                Types of Employee4

 

Regular employee

An employee who has been employed to perform necessary or desirable activities in the business or trade of the employer who is employed beyond probationary period.

 

Probationary employee

An employee hired for regular job or position after the probationary period. Where the work is learnable or apprenticeable, the probationary period is limited to the authorized learnership or apprenticeship period. If not hired as a learner or apprentice, the probationary employment period is maximum of six months period, the probationary becomes regular employee.

 

Temporary employee

A temporary employee is a person hired to perform work in a specific project, job or period, upon completion of which the worker’s employment is terminated.

 

Contractual employee

A contractual employee is one hired on an individual employment contract basis to perform work on a specific project or projects. The duration of such employment is indicated in the employment contract, which may not exceed six months.

 

Casual or seasonal employee

By connotation, a casual worker is one who is hired for only a few days or a few months at a time to perform unit of work or to fill a gap in the absence of another employee, or a worker who is hired occasionally and intermittently especially during peak production periods.

 

  VI.             Interview Guidelines3

 

1. Dress Appropriately

Ø  Neat, Clean and well-groom        

 

2. Be on time

Ø  Arrive early but don’t be late

Ø  This is the interviewer first impression of you

 

3 Bring Extra copies of your resume

 

4. Beware of body language

Ø  Try to look energetic

Ø  Display good posture

Ø  Don’t forget to smile

 

5. Give Qualitative Answer

Ø  Avoid Answering question using yes or no

Ø  Give example of your past performance

 

6. Emphasize your strength

Ø  The interview process is about selling yourself and what better way than  to market what you do best

 

7. Remain calm

Ø  Avoid nervous habit such as:

            Tapping your foot

                        Playing your hair

                        Biting your nail

 

8. Make sure your initial non-verbal contact is positive

Ø  Have a firm handshake

Ø  Establish good eye contact while talking

 

9. When asked questions always listen to their question carefully

 

10. Obtain information for yourself

Ø  Be an active in the interview process

Ø  Don’t just sit there and not ask any question

 

11. Be careful of the quickie words. They can make you sound uneducated.

 

                                                            Emphasis:       

Gonna                                     To tell the truth

            Yeah                                        Truthfully

            “y know”                                 Basically

            Kinda                                      Ok, well

 

12. Parroting Technique

Ø  If the question is unclear

Ø  Entirely appropriate to ask clarifying question or paraphrase the question to make sure you understand. “Parrot back”

Ø  “Just so I understand, what are you asking is…”

 

13. S.T.A.R Technique

Ø  Describe the Situation you were in or the Task you needed to accomplish; describe the Action you took, and the Results.

Ø  Be specific, not general or vague   

 

 

_____________________________________________________________________     

CLINICAL REFLECTION

Clinical Reflection

 

            This reflection will discuss my interaction with a mental health patient in the community and the reaction I experienced upon meeting any mentally ill patients for the first time. Through consideration of the theoretical perspectives and my own view points I will explain my feelings and attempt to interpret my reactions. I will suggest how my future behavior will be different as a result of this experience and my understanding of it.

We live in a time when mental health has been increasingly failing for many individuals. Many situations that are reflected in our societies today re increasingly convincing me, helping me to come to realize that mental health nurses matter, are essential healthcare providers, and will continue to be needed in the future. Mental health nurses are in the right position to grow in the understanding of mental health and to better identify the constructs and care practices that promote, strengthen, and protect the mental health of individuals and families.

Mental health can be a very challenging area to work in and as an experienced student nurse, I have a great admiration for the skills and commitment registered mental health nurses give. There are many qualities that a registered mental health nurse must possess. Personally, I feel that I have already developed some of these qualities given the time and experience that I have spent in the mental health field. To illustrate my capabilities, I will outline in the succeeding paragraphs the qualities that I have developed as well as the situations where I have applied them.

Mental and behavioral disorders are understood as clinically significant conditions characterized by alterations in thinking, mood or behavior, and associated with personal distress and/or impaired functioning. Mental and behavioral disorders are not just variations within the range of "normal" but are clearly abnormal or pathological phenomena. In order to be categorized as disorders, such abnormalities must be sustained or recurring, and they must result in some personal distress or impaired functioning in one or more areas of life. Mental and behavioral disorders are also characterized by specific symptoms and signs, and usually follow a more or less predictable natural course, unless interventions are made. Not all human distress is mental disorder; unless all the essential criteria for a particular disorder are satisfied, such distress is not a mental disorder. Similarly, culturally determined normal variations in thinking and behaving are not mental disorders ( 1996). These are aspects that must be considered when dealing with mental health patients.

While I was on my practice placement at a mental health clinic, I have experienced a lot of things and I have also learned many valuable lessons from those experiences. Being with the vulnerable population is an experience unlike any other I have come across. I had to make a lot of adjustments. As a student, my knowledge about behaviors of patients with mental problems is limited only to the books. And that also goes true for my knowledge on how to handle them, especially in unexpected situations. In my diary I have described my experiences during my student practice where I have learned a lot.

On my first day, I was assigned to take care of a male mental health patient and assist his needs. The next day, I was also assigned to another patient who is completely different from this one that I have previously handled. My third day patient is a 21 year old female with psychosis. She permitted me for an observation and I came inside and observed the interview and oral medication.

On that same day, we visited a schizophrenic patient. This patient was very depressed. Schizophrenia is found all over the world. The severity of the symptoms and long-lasting, chronic pattern of schizophrenia often cause a high degree of disability. Medications and other treatments for schizophrenia, when used regularly and as prescribed, can help reduce and control the distressing symptoms of the illness. However, some people are not greatly helped by available treatments or may prematurely discontinue treatment because of unpleasant side effects or other reasons. Even when treatment is effective, persisting consequences of the illness -- lost opportunities, stigma, residual symptoms, and medication side effects -- may be very troubling.

My job as a mental health nurse while taking care of the mental patients involve more than just giving them anti-depressant medications. What I was trying to achieve while I was the mental health nurse taking care of the mental health patients is to support them and relieve their feelings of hopelessness. I also wanted to show them that I care for them as a person and that everyone loves them and have time for them. I have learned that for a patient to fully heal, you have to also touch their hearts. I acted the way I did with my patients because they were obviously very depressed. I did not feel that I could just simply them her while they were in this state. I felt a need to help them develop positive attitudes for the future. I listened to everything they would want to say to me because I believe that it would help them minimize and overcome the depression that they felt from their situation. To reach out and encourage them was just one of the most natural things for me to do.

The need to remove the considerable barriers to health promotion for people who have mental health problems has long been recognized. In Australia there is commitment to community care and recognition of the importance of providing services that place the user central to service delivery. Whilst wide variations in the patterns of collaboration can be found between the health organizations and local government, it is possible to begin to identify key principles that underpin the delivery of coordinated services to the user that enhance quality of life irrespective of the particular structure through which they are delivered (2001).

Partnership is a fundamental theme in current government initiatives and is seen not only as the way to modernize statutory services but also as a catalyst to challenge the existing cultural mores within which our society operates. Within this, partnership is about developing and acknowledging our collective responsibility for the health and well-being of the community to which we belong ( 2001). Service users played a big part in determining how the partnership was set up. Brent is one of the few authorities nationwide to have a fully integrated learning disability service.

There are many personal factors which influenced the way I took care of the mental health patients. I believe that being able to listen and the application of touch are important skills in a nurse, as well as showing that you care for the patient. I also believe in my mental health patients as a person. Although I know that some of them are severely depressed, I also know that as the days went by, some of them are fighting hard to overcome it.

Many people have stigma against mental health illness. There is a lot of information regarding stigma in mental illness and the effect it has on health care workers’ attitudes towards their patients. Viewing stigma as a public health issue points to the ways in which stigma harms people with mental illness. Three are particularly notable: label avoidance, blocked life goals, and self stigma.

The public health approach to decreasing mental illness stigma largely relies on education programs dominated by the medical or disease model. Education is defined broadly in terms of any strategic format (that is, classrooms, public service announcements, magazine articles) that seeks to decrease stigma by informing the public about mental illness. One example is the National Alliance for the Mentally Ill's (NAMI) "Mental Illness is a Brain Disease" campaign, in which the organization distributed posters, buttons, and literature that provided information about the biological basis of serious mental illness. On a global scale, the World Psychiatric Association (WPA) is sponsoring its Open the Doors Global Program against stigma and discrimination focusing on schizophrenia. Now in its eighth year, the WPA information program educates the public about mental disease and corresponding treatment.

The public health approach may have some value in reducing label avoidance and limited impact on aspects of blocked opportunities and self-stigma. However, in other ways it may exacerbate stigma-related problems. What might we learn from other perspectives on stigma that will diminish its impact? When not discussing health disorders, generic ideas of stigma are typically defined as social injustice; this general definition rests on the idea of discredited difference (2001). Prejudice of any sort rests on human differences. Although the vast majority of human differences are irrelevant to prejudice--handedness, eye color, foot size--history shows some differences such as skin color and sexual orientation are salient and often paired with negative attributes.

There is also the problem of unequal treatment of mental health patients. The causes of this unequal treatment arise in part from deep-seated convictions, if not biases. Foremost is the belief that mental health and disorder are poorly defined. While few would argue today that mental illness is a myth, or maintain that mental illness is whatever psychiatrists treat, nonetheless there is a bewildering diversity of views about mental illness, ranging from biological accounts to social determinism. The nature of mental illness is often conceived as a dichotomy between mind and body, an unfortunate dualism that tends to minimize the physical suffering and disability associated with mental illness. Oddly enough, even within the mental health field there are those who wish to distinguish biological from nonbiological mental disorders and give priority to the former ( 1992).

I have learned that mental health nurses should focus on the wider needs of the patient, using their skills to improve physical well-being through better assessment and health promotion activities, and by providing more psychological therapies. Mental health nursing is at the heart of modern healthcare. Through the development of new roles, such as prescribing, and new skills in areas such as physical wellbeing, mental health nurses are at the forefront of changes in how services provide for the needs of people with mental health problems. All mental health professionals are having to rethink the part they will play in the services of the future. This report sets out an optimistic and ambitious vision of a confident and responsive nursing profession.

Mental health nursing should take a holistic approach, seeing services users as whole people and taking into account their physical, psychological, social and spiritual needs. This means that mental health nurses need to widen their skills to improve promotion activities and provide more evidence-based psychological therapies. Mental health nurses need training, supervision and managerial support.

From my research, I have learned that Integrated care, an emerging trend, offers much promise to clients and all healthcare workers (2001). Integrated care is the increased collaboration of mental health professionals within primary care settings. More specifically, integrated care is most effective when services are provided via co-location, that is, when mental health counselors work in the same offices with primary care physicians. In this type of integrated arrangement, primary care physicians and mental health professionals consult regularly throughout the day about clients' needs and will, in some situations, see a client together to help determine the most appropriate treatment plan.

For example, in one large health maintenance organization, primary care physicians and psychologists share offices. Consequently, the professionals are successfully identifying 90% of the primary care clients who need mental health services, and of those clients, 85 % are receiving treatment (2002). Reasons for this success include the collaboration between the two healthcare providers and more importantly, clients' following through with treatment, perhaps because primary care physicians can introduce clients to the mental health professionals on staff, instead of referring them to outside agencies ( 1990).

            I have also reflected that the quality of mental health care or of health care for that matter also rests on other aspects. Quality of patient care is threatened by the acute shortage of nursing staff and at times a less than optimum mix of skills and experienced staff. The consequences are felt by patients or their families as well as nurses and have implications for clinical responsibilities and vulnerability to litigation.

Due to this experience I have gained insight and will adapt my attitude and action when encountering patients with mental illness in the future. What I felt about the experience with the mental health patients is a mixture of feelings. I was very supportive with them and with their families. I wanted them to really overcome their situations if it is possible and I want them to feel that they are still loved. Some of the patients are still so young and have so much to live for. Sometimes I would feel helpless when I couldn’t make them calm down or I couldn’t stop them from crying or simply couldn’t stop them from doing weird behaviors.  

Overall, I feel better and grateful for the experience I had with the mental health patients. It brings me joy that somehow I was able to foster hope in them and in the process helped them through daily living and even get well. I will use the knowledge I have gained from this experience to apply to future situations and hopefully help other persons with mental problems.

 

 

 

 

 

 

 

 

 

 

 

 

LEVELS OF PREVENTION IN COMMUNITY NURSING

LEVELS OF PREVENTION IN COMMUNITY NURSING

 

            Many of the most serious disorders treated in health care practice can be prevented or postponed by immunizations, chemoprophylaxis and healthier lifestyles, or detected and treated early with various screening and intervention. Health care professionals, like nurses, now have the opportunity, skills and resources to prevent disease and promote health, as well as cure disease. Community nursing care oriented to health promotion, wellness, and illness prevention can be understood in terms of health activities the levels of prevention. These levels of prevention are primary, secondary, and tertiary levels which are formulated by Leavell & Clark. Each level of prevention corresponds to specific nursing and medical interventions.

            Primary prevention is true prevention. It is also referred to as specific protection. It precedes disease or dysfunction and is applied to clients considered physically and emotionally healthy. It comprises of measures applicable to a particular disease or group of diseases in order to intercept their causes before they involve the individual (World Health Organization, 2001).

Primary prevention aimed at health promotion for the community includes health education programs, immunization for the children, and physical and nutritional fitness activities. It can be provided to an individual or to a general population, or it can focus on individuals at risk for developing specific diseases (Potter & Perry, 2004).

Wellness activities are synonymous with the activities identified for primary prevention. Primary prevention includes all health promotion efforts, as well as wellness activities that focus on maintaining or improving the general health of individuals, families, and communities (Edelman & Mandle, 2002).

For health promotion, activities includes health education, good standard of nutrition adjusted to developmental phase of life, attention to personality development, provision of adequate housing and recreation as well as agreeable working conditions in communities, marriage counseling and sex education, genetic screening and periodic selective examinations. Activities geared towards specific protection include the use of specific immunizations, use of environmental sanitation, protection against occupational hazards, protection from accidents, use of specific nutrients, protection from carcinogens, and avoidance of allergens (Potter & Perry, 2004).

            Primary level of prevention could be used to address issues in a community experiencing increasing level of family violence. Educating the individuals in the community regarding violence, how to stop them and how to avoid them could largely help in decreasing the levels of violence in the community. Activities that could help individuals occupy their time could shift thought of violence behavior to a more productive one. Thus by using primary prevention, individuals could be directed to do more productive activities than produce violence. Other than that, marriage counseling could help minimize the levels of family violence in communities. When couples and other family member would undergo counseling, issues and problems could be solved and violence prevented.

            Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. This is basically the level of prevention that focuses on treatment. It refers to measures to arrest a disease process already initiated, in order to prevent further complications and sequelae, limit disability, and prevent death (World Health Organization, 2001). Activities are directed at diagnosis and prompt intervention, thereby reducing severity and enabling the client to return to a normal level of health as early as possible (Potter & Perry, 2004).

            A large portion of nursing care related to secondary prevention is delivered in homes, hospitals, or skilled nursing facilities. It includes screening techniques and treating early stages of disease to limit disability by averting or delaying the consequences of advanced disease.

            Early diagnosis and prompt treatment for secondary prevention include case-finding measures and selective examinations to cure and prevent disease process, prevent spread of communicable disease, prevent complication and sequelae, and to shorten an individual’s period of disability. Activities for disability limitations include adequate treatment to arrest disease process and prevent further complications and sequelae, and the provision of facilities to limit disability and prevent death (Potter & Perry, 2004).

            Tertiary prevention occurs when a defect or disability is permanent and irreversible. This level of rehabilitation involves measures aimed at disabled individuals, restoring their previous situation or maximizing the use of their remaining capacities (World Health Organization, 2001). It also involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration (Edelman & Mandle, 2002). It therefore comprises both interventions at the level of the individual and modifications of the environment.

            Activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help clients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is preventive care because it involves preventing further disability or reduced functioning (Potter & Perry, 2004).

            Examples of activities that focus on tertiary prevention includes provision of hospital and community facilities for retraining and education to maximize use of remaining capacities, education of public and industry to use rehabilitated persons to fullest possible extent, selective placement, work therapy in hospitals, and use of sheltered colony (Kozier & Erb, 2004).

Preventive care cannot be delivered effectively without active client involvement. At the most basic level, clients must consent to receive preventive care. In the case of family members in the community that agree to undergo preventive treatment in order to reduce levels of violence, they must wholeheartedly consent to such an intervention. Every effort should be made to foster patient knowledge and interest in preventive care with the use of various educational materials. Members of communities must be thoroughly educated and health care professionals should come up with strategies that gauge if these individuals have indeed learned something, and if the intervention is indeed successful. These may be made conspicuously available at strategic locations throughout the office or clinic, as well as actively distributed to clients with special needs.

A comprehensive health care program should address all three levels of prevention. The nurse should develop a health care program that would focus on (1) health promotion and protection against specific disease problems and decrease probability of diseases, (2) early identification of health problems and prompt intervention to alleviate health problems and include specific screening programs and illness care, and (3) chronic disease rehabilitation to an optimal level of functioning and relates to situations where a disability is already present in an individual. Granting the fact that communities comprise of very diverse individuals with different demographic, sociopsychological and structural variables, nurses and other health care professionals must come up with a health care program that is comprehensive enough to cover such a diverse population and the diverse levels of illness and disease that come with them.

Addressing a health concern at this level of prevention is cost effective since it is like hitting three birds with one stone. By preparing for whatever could possibly happen to an individual in a community, the nurse could save time, effort and money in the prevention of illness and diseases. Perhaps in the primary level of prevention alone, this could help stop the spread and development of illness and diseases in the members of the community. Identifying risk factors, attempts to eliminate the stressor, focuses on protecting and strengthening defenses could help individuals from developing diseases and illness. If that is the case, not only will the health care professionals save on time and effort but the individuals in communities could also save costs on treatment for secondary prevention and even rehabilitation for tertiary prevention.

            In conclusion, health care professionals most especially nurses must develop health care plans and strategies geared on prevention and taking into account the three levels of preventive care. A comprehensive health care program should address all three levels of preventive care. Aside from being an advantage since it could be used on any individual in the community, it is also cost effective. Individuals in communities and health care professionals must always remember that prevention is still better than cure.

A Research Proposal Paper on Training & Development in Banking Industry in Pakistan

Training & Development in Banking Industry

Introduction

Within the banking practice the use of the integrated accounting principle and standards are very unique that it still leaves the competency in the performance of the banks. In order to have the quality type of service, the hiring and employment in banking institutions is advisable to continuously promote the service and yet, find solutions in the growing number of problem of the financial users. Therefore, the solution that is preferred by most of the leaders is the use of training and development which seems to be feasible for the banks in Pakistan.

Background and Problems Statement

Many studies consider the effectiveness of the performance of the employees which is vital to support the continuous growth of the business. It is important for the organization in global environment to have a competitive performance. Often, the performances are based on the abilities of the people to deliver the knowledge and skills. This same idea is true in banking sector, wherein the performances are the after sought contribution of the employees for the organization. The effectiveness of an employee is manifested in the performance of the organization. Due to this fact, the increase number of opportunities available makes an impact in employee turnover (Akhtar, 2006). The paper addresses the two problems that will be the center of the entire study:

1.      What is the impact of training and development in banking industry particularly in Pakistan?

2.      What are the ways to provide the improvement among the employees of banking sectors?

Research Aim and Objectives

The main aim of the study is to investigate the idea of training and development within the banking institutions. In order to manage all the related information well, there are four objectives that need to be satisfied. First is to recognize the actions of the banking institutions in improving the performance of the staffs. Second is to measure the ability and capacity of the employees in managing the changes and challenges involved due to the growing financial problems and demands. Third is to demonstrate perceptions of the individuals regarding the training and development in the industry. And fourth is to recommend interventions in training and development of staff to accompany them in their performance.   

Literature Review

The banking industry enables to compete in the world of global financing for the bank itself is applying the principle of corporate governance. In the world of the competitive industry, the economic development can be reflected in the continuous corporate financing (Ali, 2007). Most of the banks in Islamic region focus on strengthening the banking practice by adopting the Islamic banking.  The singular practice in the Islamic banking is considered as the professional practices in the business environment that can be easily renew the interest and compete in the Western practice (Maurer, 2002). In the international level of the Pakistan’s bank known as the State Bank of Pakistan, there is a goal that the industry needs to pursue in strengthening the links with the International Islamic Infrastructure Institutions. Also, the banks in Pakistan is attempting with the multilateral development. This means that the adaptation of the Islamic banking practices in Pakistan is inevitable. In addition, Pakistan Islamic banking is emerging as a response to both religious and economic needs. Their effort to take the progress and continuous development can be done through allowing the new fully fledged Islamic banks in the private sector. Furthermore, the country allows the conventional banks to set the Islamic banking subsidiaries, and then allowing the existing conventional banks to open the Stand-alone Islamic banking branches (Sarfraz, 2007). The financial stability of the country is the main aim of the implementation of Islamic banking industry. And its role and support in the institution can be the center of the system. However, focus in empowering the employees to seek their competency is missing in the banking industry.

Methodology

The suggested methodology that can be successfully applied in the study is to use of both qualitative and quantitative research. At first, the secondary information will be used by gathering the previous studies that centers in the application of training and development in banking and finances in most of the countries is great advantage for the study. On the other hand, through the use of survey and interview, the study can determine the perception of the employees in banking industry as well as to measure the effectiveness of training and development for the performance of each employee. 

 

References:

Akhtar, S., (2006) Shamshad Akhtar: Pakistan’s Capital Markets – Mobilizing for Growth [Online] Available at: http://www.bis.org/review/r070117g.pdf [Accessed 01 October 2010]

Ali, S.N., (2007) Islamic Finance and Economics as Reflected in Research and Publications, Harvard Law School [Online] Available at: http://www.inceif.org/_system/media/pdf/global_forum/speech_nazimali.pdf [Accessed 01 October 2010].

Maurer, B., (2002) Anthropological and Accounting Knowledge in Islamic Banking and Finance: Rethinking Critical Accounts, Journal of the Royal Anthropological Institute, 8(4).

Sarfraz, A., (2007) Pakistan’s Islamic Banking Sector Review, Islamic Banking Department, State Bank of Pakistan [Online] Available at: http://www.sbp.org.pk/ibd/Islamic-Bkg-Review-03-07.pdf [Accessed 01 October 2010].