Learning Skill Essay

?The attributes of the learners and how they can help the learners to be successful in an online learning environment Education of children is compulsory, formal and standardized. Adult learning is voluntary and intentional. The purpose of adult education is the independent self-directed learner. Adults tend to resist a learning process which is incongruent with their self-concept as autonomous individuals and does not correspond to their needs and interests. Adults focus on direct application. Given their daily duty in job, profession, family and community, they learn to cope with the pressures and problems of life they are facing. For that reason, the adult educator’s concern is primarily focused on the needs and interests of the learners. â€Å"Andragogy (adult education) calls for program builders and teachers who are person-centered, who don’t teach subject matter but rather help persons learn† (Knowles). Hence, the interests of adults are their real needs. Or the solutions learners have in mind do not solve their problems. The adult educator often has to register into a â€Å"needs negotiation† (Bhola) with learners when teaching new needs about boiled water or a balanced diet, about clean surroundings, preventive health practices or small families. In the dialectical process of needs negotiation the needs as felt by the learners and the needs as seen by the adult educators must be showed together to reach a consensus on the â€Å"real† needs. These real needs must agree to the experience of adult learners. If an adult gets the impression that his experience is not being valued he feels turned down as a person. New learnings take on meaning as adults are able to relate them to their life experience. Experienced adult educators, so, build into the design of their learning experiences provision for the learners to plan and rehearse how they are going to apply their learnings in their day-to-day lives or duties and combine training with transfer and application. A workshop then really can become a workplace where educational materials are produced or evaluation studies are designed. According to Knox’s proficiency theory the learning needs for an adult move upward from life situations and interpersonal communication. Social expectation motivates and empowers an adult to search for more knowledge, better expertness and more suitable performance. Adult learning is based on experience, on the learners’ own experience and on the experience of others. Learning settings of adults usually have a participatory and collaborative basic part. Adults prefer to meet as equals in small groups to explore outcome and concerns and then to take common action as a result of dialogue and inter-learning by discourse. The group becomes the â€Å"learning co-operative†. The group provides the opportunity for inter-learning. Within the group the teacher as well as the other group members plays the task of facilitators. All group members become â€Å"co-agents† (Bhola) in learning. The absence of formal accreditation or certification facilitates collaboration not only on a specific product or outcome but even in structuring and restructuring the learning process according to the needs and interests of the group. The learning process becomes as important as the learning outcome, and a balance between both is often not easy to maintain. How much freedom can actually be given to the adult learner in choice of content and way? Adult learning is life-centered. It is learning by doing, by application and experience, and if need be by trial and error. Adults do not simply to get knowledge created by outsiders, but should examine their own reality themselves and make a positive declaration about it. â€Å"Praxis† is the focus of effective adult learning and praxis means analysis and examination of reality in order to transform it. Adult learning is without interval process of investigation and exploration followed by proccess of doing something grounded in this exploration, followed by reflection on this action, leading to further investigation and so on. The principle is testing not â€Å"banking† (P. Freire) of knowledge. Exploration of new opinion, skills and knowledge take place in the context of the learners’ experience. In settings where skills are being learned, learners become acquainted with skills, apply these in real life settings, redefine hoe these skills may be altered by context, re-apply these in other settings and so on. Adults explained the meaning of ideas, skills and knowledge through the medium of their life-experience and test them in real life settings. To make the learner self-directed is the intention of adult education. But the self-directed learner is neither the one who can retrieve information or locate resources nor the one who appears in group dynamics. The â€Å"inner-directed, self-operating learner† (R. Kidd) is the one who reflects critically on his own assumptions and is keen to find alternative and better solutions. The learning process contributes largely to the success of learning. But learning is more than just the learning process. A participative learning process which fails to assist the learners in  acquiring knowledge and competence is a failure. A participative learning process may take more time because it means active involvement of everybody, discussing all the pro’s and con’s, despite that it must lead to concrete results combining commitment with competence. Education is, as Brookfield points out a â€Å"transactional encounters†. That means that the sole responsibility for determining curricula or for selecting appropriate methods does not rest either with the educator or with the learner. If the first acquires, then we have an authoritarian style and a one-way transmission of knowledge and skills. If curricula, methods and evaluative criteria become predetermined solely by what learners say they want, then the â€Å"cafeteria approach† governs the educational process. Accepting the felt needs logical basis without any further inquiry and needs negotiation means that the facilitator has to give up responsibility for the learning process and the accomplishment of learning aims and objectives. Successful learning especially in workshop settings means to keep the balance between the learning process and the learning outcome so that the results justify the efforts and if they are not excellent they should be at least and always â€Å"good enough†. Successful distance learners are self-motivated, self-reliant and self – disciplined. Distance learning students are the architects of their own learning surrounding, have the ability to manage their study time and schedule. Students can often customize their learning projects to fit their personal interests and there is great chance for personal growth and individual academic success. This requires both internal personal motivation and discipline, and also requires the establishment of a supportive personal learning environment and may require elimination of certain activities to make room for online learning in daily life. Distance learners should be self – sufficient, self-directed individuals. The online environment enables students to learn at their own pace, relieving some of the pressure of traditional seated learning and making learning more enjoyable but requires that the student is able to identify learning goals and objectives and focus their attention accordingly. Distance learners become independent problem solvers, doing their own research and expanding their lifelong learning skills. This process helps them to grow critical thinking skills and the ability to interpret and synthesize reading materials, articles and research papers with differing points of view and in the process develop their own positions and beliefs about the subject matter. Some computer and Information literacy is necessary for a distance learner. Distance learners should possess a working knowledge of email, the Internet, and basic keyboard skills. Instructional material within the learning management system will provide all the other skills needed to access and begin the online or distance lesson. Distance learners may be required to develop skills for researching and locating information from several sources and differentiate and assess them for inclusion in distance learning assignments and research projects. Distance learners should be energetic and disciplined managers of their own time. Students must be able to organize and plan their own best study schedule. While individual learners may prefer a different time of day or times in the week to give up to their distance learning study and projects, it is important to devote time each week to course work and it is vital that the distance learner understand that the same amount of time is involved in distance education courses, and traditional seated courses. The distance learner should assess his or her best time of day for study, either it is early morning or evening, every person has a best time of day for learning and thinking. A intentional effort must be made to carve out time in the student’s daily schedule for an optimal study time. Study time should not be the time that is left at the end of the day, unless that is the time when the student is most lively and attentive. All learners and especially distance learners need effective communication skills. The particular nature of distance education requires that communication be done in a written format, whether it is email, written assignments or discussion forums, the written word is vital in distance education. The ability to write clearly and communicate ideas becomes more important since it is the primary means of communication in distance learning. The successful distance learner has a strong sense of responsibility and personal commitment to academic success. Online learning, like many things in life, reaps rewards equal to the energy put into the changes. The independent nature of distance education to insist upon the presence of motivation, and discipline but commitment and follow-through are also vital.

Fire Science Fair Project Ideas

Fire Science Fair Project Ideas Are you looking for a science fair project that involves fire or combustion? Here are some ideas for fire projects to get you brainstorming. What chemicals burn in different colors?What substances can mask the colors of flames?Which type of oil produces the least soot when it burns? You can collect soot (carbon black) by burning in a container and wiping it down between tests or by examining a filter paper (or coffee filter) placed in with the test oil.Analyze whether burning trash is a good alternative to landfills.Examine the effects of flame retardant chemicals on growing plants or on animals, such as insects or aquarium fish.Which common materials (e.g., paper, foam, cloth, vinyl) produce the worst smoke/air pollution when burned?Examine how controlled burning is used for forests and parks.Examine the effects of ash on soil composition.How does diminishing oxygen affect the appearance of a flame?Does it matter what type of wax is used to make a candle?Can you construct candles using liquid oils or other fuels besides wax? More Science Fair Project Ideas

The Characteristics of a Compelling Introduction

The Characteristics of a Compelling Introduction An introduction is the opening of an essay or speech, which typically identifies the topic, arouses interest, and prepares the audience for the development of the thesis. Also called an  opening, a lead,  or an introductory paragraph. For an introduction to be effective, says Brendan Hennessy, it should  persuade readers that what you have to say is worth close attention. Etymology From the Latin, to bring in. Examples and Observations In addition to appealing to readers and helping them to anticipate tone and substance, the opening passage can also help readers read by helping them to anticipate the structure of what will follow. In classical rhetoric, this was called the division or partition because it indicates how the piece of writing will be divided into parts. Methods of Introducing an EssayHere are a few possible ways to open an essay effectively:State your central idea, or thesis, perhaps showing why you care about it.Present startling facts about your subject.Tell an illustrative anecdote.Give background information that will help your reader understand your subject, or see why it is important.Begin with an arresting quotation.Ask a challenging question. (In your essay, youll go on to answer it.)Example of Introductory Paragraph in an Essay Bill Clinton loves to shop. On a March day in an elegant crafts store in Lima, the Peruvian capital, he hunted for presents for his wife and the women on his staff back home. He had given a speech at a university earlier and just came from a ceremony kicking off a program to help impoverished Peruvians. Now he was eyeing a necklace with a green stone amulet. Four Goals of IntroductionsAn effective introduction has four basic goals:Catch the audiences attention and focus it on your topic.Motivate the audience to listen by pointing out how your topic will benefit them.Establish credibility and rapport with your audience by creating a common bond and letting them know about your expertise and experience with the topic.Present your thesis statement, which includes clarification of your central idea and main points.Examples of an Introduction in a Speech The first thing I would like to say is ‘thank you.’ Not only has Harvard given me an extraordinary honour, but the weeks of fear and nausea I have endured at the thought of giving this commencement address have made me lose weight. A win-win situation! Now all I have to do is take deep breaths, squint at the red banners, and convince myself that I am at the world’s largest Gryffindor reunion. (J.K Rowling) Quintilian on the Appropriate Time to Compose an Introduction (or Exordium) ï » ¿I do not, on these accounts, agree with those who think that the exordium is to be written last; for though it is proper that our materials should be collected, and that we should settle what effect is to be produced by each particular, before we begin to speak or write, yet we ought certainly to begin with that which is naturally first. No man begins to paint a portrait, or mold a statue, with the feet; nor does any art find its completion where the commencement ought to be. Else what will be the case if we have no time to write our speech? Will not so preposterous a practice disappoint us? The orators materials are, therefore, to be first contemplated in the order in which we direct, and then to be written in the order in which he is to deliver them. Pronunciation in-tre-DUK-shun Sources Brendan Hennessy, How To Write Coursework and Exam Essays, How To Books 2010.Richard Coe,  Form and Substance: An Advanced Rhetoric. Wiley, 1981X.J. Kennedy et al.,  The Bedford Reader. Bedford/St. Martins, 2000Introduction to Its Not About Bill, by Peter Baker.  The New York Times Magazine, May 31, 2009Cheryl Hamilton,  Essentials of Public Speaking, 5th ed. Wadsworth, 2012J.K. Rowling, commencement address at Harvard University, June 2008Quintilian,  Institutes of Oratory, 95 AD

How official sponsors have been affected by the activities of ambush Essay

How official sponsors have been affected by the activities of ambush - Essay Example This research will begin with the definition of ambush marketing. Crimmins and Horn define ambush marketing as the act in which a corporation takes advantage of a well known event like FIVA tournaments in football to popularize itself without an official permit from the concerned party. It is considered to be a form of marketing strategy in which one of the many competing companies associates itself with a particular sporting event, without paying the required fee. The company associates itself directly with the event and it’s participants without an official permit, creating an unfair competition with the official sponsors. The aim of the ambush marketing is to popularize their company by influencing fans to buy their products. They only associate themselves to the event but do not use trademarks of the third party while only suggesting a close connection to the event by creatively alluding themselves to that event. Generally, ambush marketing can be demonstrated in one of th e following ways such as through sponsorship of the event’s broadcasting. Lyberger and McCarthy concurs that this will work to their advantage since it will popularize itself among the fans through the televisions covering the event. Secondly, the ambush marketer might also sponsor the event’s subcategories and hence boosting their association through a cost-effective method. Another strategy ambush marketers employ is to buy time to advertise themselves during their competitors’ event. Furthermore they can as well organize for similar but non-sponsored events to run co-currently with the event. Finally, the ambush marketers can opt to buy licenses allowing them to sell their products during the event or offer unsanctioned tickets and hospitality packages to fans of the event. This paper discusses a case study of ambush marketing in India. Case Study Vikrant (2003, p.34) examines India as one of the many countries which have been affected by the activities of th e ambush marketers during the 2003 Cricket World cup. One of the cases was triggered by a promotion dubbed Phillips, which was offering Cricket World Cup tickets as prizes. The slogans that were used during the promotion indicated the name â€Å"Philips† and they urged interested candidates to buy an audio system from Philips and get one cricket world cup ticket (O’Sullivan and Murphy, 2000, p.366). In addition, the tickets indicated a seating place for someone and the entry number at the gate. This incidence caused a lot of suspicion since the Philips Sponsor had no official recognition among the sponsors of the event. Lyberger and McCarthy (2001, p. 134) explains that during that year the International Cricket Council (ICC) had signed official agreements with nine sponsors who were officially recognized. It came to the attention of the council that the sponsor calling itself Philips was not among the nine sponsors. Consequently, the council presented claims that the Philips Sponsor was trespassing and offering unfair competition to the recognized official sponsors. The sponsors of Phillips were an ambushing marketer and the council filed a suit restraining the sponsor from associating its advertisements to the world tournament (Vikrant, 2003, p. 38). However, this was a belated afterthought as the ambush had already caused a lot of damage to the official sponsors and stopping the adverts could not reverse its gains to Phillips. Matters were further complicated by the fact that a case presented to an Indian court by the council was dismissed on grounds that the information contained in the Philips Slogan was just a form of advertisement (Natal, p. 2003). According to the court, Philips was just looking for a way to attract many people to buy their products, which doesn’t amount to an infringement. It interpreted the information in the slogan as any person purchasing goods form Philips would be awarded a prize, only that the prize was the

Strengths and Weaknesses of Porters Five Forces Analysis Essay - 1

Strengths and Weaknesses of Porters Five Forces Analysis - Essay Example From this study, it is clear that the model was framed way back in the 1980s when the business trend was much more different than it is today. It provides a general overview of the external environment. Any new business can use it to analyze the market they are entering before starting their venture and customize their plan according to the results obtained from it. Though there are certain limitations, it covers more or less all the aspects a businessman should consider before starting a new venture. As the study outlines Porters five forces model is by far the most simple and easiest tool to understand the industry structure. Understanding the industry structure is vital to plan effective strategies to gain a competitive edge. Industry structure is nothing but a set of characteristics which is shaped by the economic and technological factors prevalent there. Understanding the causes which determine the success or profit of one particular brand will help others plan their strategy accordingly. Porters five forces analysis helps them do the same. For example, consider a person wants to start an online shopping website. There are already thousands of shopping websites on the internet. They have to give something new and attractive to the customers and manage the heavy competition from others. Porter’s five forces model acts as a checklist of the new businessman enlisting all the important entities to be checked. They prompt them to check the core competitors in the industry first like eBay. The website owner might decide to cater the needs of certain kind of people interested in high-class antique products, as there are so many websites selling apparels and related accessories. Second, Porters model prompt them to check the threat of new entrants and substitutes.

Commercialization Essay Example | Topics and Well Written Essays - 1750 words

Commercialization - Essay Example The accomplishment of various objectives and goals of the organization will be done through excellent commercialization techniques (Environment.fi, 2012). Commercialization includes technological services like linking of technological delivery and endorsements (Harzing & Noorderhaven, 2000; Cai, 2000). In order to commercialize new product development the technology used must match with the specifications and requirements (Santamaria & Ni, 2008). Commercialization of a new product allows the company to create differentiated products with and against the customer’s choices along with various values dimensions (Narotama, n.d.). To gain maximum value from the products and product developments services commercialization helps in gaining high return on investment from product development and also attain a market position relative to its competitors (Shirani, 2009). External Factors Responsible for Commercialization in the International Markets Cost: The cost of the raw materials an d labor is required for the manufacturing of a new product and whether these factors would turn out to be costly or cheap or huge determinants for the success of the new product development. Materials and technology: The availability of the raw materials and technology influence the product design. Customer Requirements: The customer tastes, preferences and requirements influence the product design. The changes in the product design are done accordingly to the customer wants and requirements. Culture: Culture plays an important role in the determination of the new product launch. The culture of a particular country plays an important role in determining the success of new product launch. Environment factors: While designing a new product, factors like whether the materials (Edgell, Ruf & Agarwal, n.d.) can be recycled or they are environment friendly or not are important determinants for new product development. Company Image and Identity: Perception of the brand image among the cus tomers plays an important role in the new product development process and the product design. Competitors: The impact of the brand image of the competitors needs to be considered while executing a new product development process. Government rules and regulations: The government rules and regulations play an important role in the development and commercialization of new product. Internal Factors Responsible for Commercialization Changing Market Dynamics: The standardization of the product design would be affected by changing market dynamics and would be established which would lead to an increase in the organizational outcome. Dominant Product Design: Dominant design would be defined as establishing a standard which would be inherent to the overall industry standards. Network Externalities: Network externalities would be existent only in those products where the perceived customer utility is available and the success of the product depends upon the taste of the existing customers and the easy availability of the complementary products (Morrello, 2013). Commercialization Models: A commercialization model is prerequisite for the companies

Personal Reflection On Infection Control In United Kingdom Nursing Essay

Personal Reflection On Infection Control In United Kingdom Nursing Essay It is highly believed within the health care industry that Healthcare Associated Infections (HCAI) are a grave worry and concern for the public of the United Kingdom (Nunkoo and Pickles 2008). When it is considered that Clostridium Difficile, commonly referred to as C-diff, is a HCAI it is made apparent that the public are greatly aware of this problem due to the fact that a high percentage of people are aware of this infection (Bosanquet 2009). The Healthcare Commission (2005) have also noted their concerns over this problem both the actual problem clinical areas have at the moment and also the potential problems that C-diff actually poses within hospitals a concern that the Department of Health (2009) also holds. These problems are also acknowledged by numerous additional sources who suggest that infection control in itself is required to be heightened in awareness and practice (Jenkinson et al 2006) making it a significant factor within primary care, a statement which is reiterated by the Nursing and Midwifery Council (2006). Due to the significance of this issue the author has chosen to reflect on an incident that she encountered whilst on placement within an acute hospital ward regarding this matter. The author has chosen to reflect on this particular incident she encountered using Johns reflection model (1990) with the intention of accessing, making sense of and learning through a specific experience (Johns 1994). The situation chosen for reflection has been classified by the author as being a critical incident. This claim is due to the fact that the experience resulted in thought provocation. Smith and Jack (2005) agree with this when they claim that a critical incident is an experience that results in individuals thinking about what has happened or indeed what is happening, resulting in the provoking of thought within an individual, just as happened in the authors experience. Description Whilst on placement within an acute hospital I encountered a situation that provoked thoughts and feelings within me alongside a desire to further research the subject. I was on a morning shift and was asked by another staff member to help them with a lady patient in a side room that was being barrier nursed due to her being positive for c-diff. Before entering the room to assist the staff member I washed my hands and put on my apron and gloves and then continued to help the staff nurse with the patient. When the task had been completed I proceeded to take the cardboard liner out of the commode and checked with the staff nurse that I was to leave my protective clothing on whilst leaving the room to go to the sluice and dispose of the patients waste and the cardboard liner. The staff nurse told me that hospital policy stated that I would be right in doing exactly that and therefore I proceeded to do so before removing my protective clothing and washing my hands. REFLECTION For this reflective assignment the author has chosen to use Johns (1990) model of reflection due to the belief that she holds that this will ensure that she is to delve through her rationale for actions and the feelings provoked. With regards to this particular incident the author intends to reflect-on-action so that the experience of the situation can be turned into knowledge therefore providing the oppurtunity of being able to learn from what occurred. Jasper (2003) suggests that this is credible due to the fact that reflecting-on-action as opposed to in-action changes the experience of the individual into knowledge. What is c-diff? what does it do? How often does it occur? In 2007 The Health Protection Agency (2007a) reported that there were over fifty thousand noted cases of c diff that presented within individuals over the age of 65. What is it now What does office of national statistics say HPA claim reduction Who does and who doesnt All hospitals are legally bound to ensure that legislation is followed by all staff something that is stated by numerous differing government led organisations including the Health and Safety Executive (2003) who reiterate the statement made by the Health and Safety at Work Act (1974) that states HOW MANY HOSPITAL TRUST DO THIS? STATISTICS The documents Winning Ways (DH 2003a) and the Matrons Charter (2004) outlined important areas in the control of infection and acted as a catalyst for local action. According to Shuttleworth (2007) local targets have been set to reduce C diff by twenty five per cent by introducing initiatives to improve knowledge, practical skills in infection prevention and control such as guidelines recently updated (Pratt et al 2007) and DHs and National Health Service (NHS) Modernisation Agencys Saving Lives: A Delivery Programme to Reduce Healthcare Associated Infection (2005). The government (DH 2007b) provided tools and resources to embed robust infection prevention endorsed by the HCC (DH 2007c) by publishing Essential steps to safe, clean care that mirrors Saving Lives but is specific to primary care. These are based on standard principles of infection control such as isolating patients and implementing barrier precautions that must be applied routinely to prevent HCAI transmission (Gould 200 9). Defining the role of the nurse is a difficult task however the role the nurse has within infection control measures is that they are responsible for ensuring that policies and procedures are always followed. It is agreed by Health Protection Agency (2007) AND The Royal College of Nursing (2008) that one of these roles of the nurse is to ensure that individual patients that are confirmed to have c-diff are placed in a side room where they have access to their own toileting fascilities. WHY IS THIS. As stated this is the nurses role however this is not always possible to fulfill due to the fact that side rooms are not always available and the actual layout of wards within hospitals often limit the possibilities of individual toilet fascilities HOW DO I KNOW THIS/. WHEN THIS IS NOT POSS WHAT ARE THE RISKS? HOW FAR CAN SPORES TRAVEL? WHO SAYS WHAT ABOUT THIS SITUATION Johnson and Gelding (2004) claim that even after thoroughly cleaning patient areas C-diff spores can still be found a claim that suggests that after a patient is moved out of a sideroom if they had c-diff confirmed whilst they were being nursed in the room even after cleaning the contamination risk is still apparent. WHAT DOES HCC SAY ABOUT THIS? AND ANYONE ELSE? EXPAND THIS. How does cdiff spread? Hands, environment? Air? Hall and Horsley (2007) suggest that c-diff spores can be spread to patients from the environment however it is individuals who visit the hospital not following the requested hand hygiene that is blamed by Banfield and Kerr (2005). WHICH IS IT OR IS IT BOTH WHO SAYS SOME PEOPLE CLAIM THAT THERE ARE NO SPORES IN THE ENVIRONMENT AT ALL BUT WHO HAND WASHING After washing hands they must be completely dried using a paper towel that is then disposed of (Johnson and Gerding 2004) however this is not agreed by Yamaoto et al (2005) who claim that drying washed hands using warm air may well be a more successful way of limiting bacteria that may be on the hands. WHAT DO NICE SAY AND RCN AND DOFH Arguably hand washing can be classified as being one of the important and utmost effective methods of reducing HCAI (Pittet et al 2000). The World Health Organization (2004) holds this to be at the forefront of its Global Patient Safety Challenge something that Gould et al (2007) supports. Hand washing is advised to be done at specific times within situations in a healthcare setting one of which is before and after contact with any patient (Department of Health 2008). The National Institute for Clinical Excellence (2003) support this statement along with numerous additional governing bodies. The Department of Health (2008) continue that when hands are washed they should be done so with soap and water. The rationale behind this method was recommended in 2001 by the Infection Control Nurses Association due to the fact that soap and water supporting the correct technique helps the skin oil layer to be removed which is the one that retains c diff spores. In addition to this it is suggest ed that the hands are dried once again by a specific and rigorous technique which uses a paper towel that is deemed to be disposable (Johnson and Gerding 2004). This claim is not supported by everybody, Yamaoto et al (2005) believe that drying hands with a paper towel is less effective than leaving them to dry by air, suggesting that this technique would minimize the amount of becteria present on the hands. Alcohol gels are nowadays commonly used therefore rendering soap and water as replaced in many situations and environments. Using alcohol gel prior to and post patient contact is a recommendation that NICE (2003) supported with the exception of when hands can be seen to be soiled to the naked eye. NICE (2003) recommend using an alcohol-based hand-rub before and after patient contact, unless hands are visibly soiled of which case then implement liquid soap and water and an effective hand-washing technique. EPIC 2 (DH2007e) support this claim though believe alcohol is not effective against C diff microorganisms and suggests the nurse must consider the need to remove transient and/or resident hand flora. Non-compliance of this suggestion EPIC 2 (DH 2007e) believe presents a direct clinical threat to patients. Wilson (2006), Pellowe et al (2007) believes hand hygiene technique and the principles of infection control are too complex for staff to comply or perhaps too complicated for healthcare professionals to in-cooperate into everyday routine (Yamaoto 2005 et al). Jenkins (2004) recognizes staff hand hygiene is poor and is part of the nurses role (Supported by DH Chief Medical Officer 2002). IS IT LOW STAFFING LEVELS OR WRONGLY PLACED EQUIPMENT OR INDIVIDUAL NURSES ATTITUDES THAT AFFECTS HAND WASHING IT IS PART OF THE NURSES ROLE Jenkins (2004) suggests that hand hygiene of health care staff is not at a high level despite it being part of the nurses role within the hospitalà ¢Ã¢â€š ¬Ã‚ ¦.WHO SAYS IT IS NURSE ROLE The following of stringent infection control policies and regulations often are not carried out which is something that can be due to numerous different factors. Different organisations and individuals put the blame for any lapses in infection control procedures down to different things including the belief that it is the mixture of skills and qualifications that are employed on a ward (Pellowe et al 2007). Additional factors believed to be responsible include the attitudes held by individual staff and the social norms of the actual ward environment (Pellowe et al 2007) however this is not the main influencing factor believed by all. Hugonnet et al (2007) suggest that they are in agreement with the idea of the ward environment playing an important part as they claim that the positioning of equipment for example sinks and cleaning products is something that can increase or decrease infection control guidelines being followed. This in itself is not something that is agreed by the HCC ( 2006) who state that the spread of infection within hospital settings is heightened due to shortage of staff on wards. However, the author believes that if shortage of staff was to blame then poor infection control would be evident on all wards that have this denominator which is not the case. DISPOSABLE GLOVES, APRON It seems that numerous organisations agree that to reduce the risk of cross contamination and infection itself protective clothing should be worn. The government themselves state that disposable aprons and gloves should be worn by all staff when caring for individuals whom are not only confirmed to be infected yet also when they are suspected to be (Department of Health 2007a). This is reiterated by the Royal College of Nursing (2008) who also suggest that this is important in reducing infection. There is some contradiction in beliefs regarding the use of plastic disposable aprons after hand washing with Hateley (2003) suggesting that this prevents any microorganism to clothing transmission, this is reiterated by numerous people including Wilson et al (2007) and HCC (2006). This is not agreed by Babb et al (1983) when they claimed that microorganisms are not completely prevented by the use of these specific aprons however a reduction was believed to occur. Gould (2009) take this one stage further in the suggestion that upon exposure to any excreta aprons should be worn before stringent disposal immediately after exposure, a statement that is supported by NICE (2003). Although there is agreeance between NICE (2003) and Gould (2009) there is no specific specification that denotes when gloves should be changed, be it before leaving the particular isolated environment or after. It is stated that wearing protective clothing of any sorts is not necessary upon the entry into an isolated environment (Gould 2009) however this same author claims that when in practice protective clothing should be worn at all times due to the chance of patients requesting assistance. This somewhat contradicts the first claim that protective clothing is not required when entering high risk areas yet is actually required in general practice upon the pretense that help could be asked for. It can be seen from this that the evidence and recommendations with regards to protective clothing are somewhat confusing at times. Derbyshire County Barrier Precautions Policy (2007) further add to this confusion when they stipulate that before leaving any infected area gloves should be removed suggesting that they should actually be worn in the first place. This policy then continues with a suggestion that any members of staff with any materials needing maceration should indeed change their gloves at just before the point of actually handling the door to the sluice, alongside this they claim that protective clothing should indeed be worn throughout the whole of the task until completion. If Gould (2009) is to be followed then no protective clothing would have been worn in the first place in the isolated area. This confusion only enhances with the addition of clinical waste disposal, something that by admittance by is found to be confusing to members of the healthcare team (Gould 2009). Following the recommendations of Gould (2009) any items for the macerator should be taken directly into the sluice whilst protective clothing is still being worn resulting in immediate disposal in the macerator. The protective gloves and apron is then said to be required to be discarded into correct refuse prior to washing hands. Gould (2009) continues to state that in an ideal world any patients that may be infected with c diff should have one of either their own individual en suite toileting facilities or their own individual commode. The later of these two statements has enhancement from the Department of Health (2008) who state specifically that this commode should not leave the patients room. So clearly from these authors and organisations it can be clearly seen that the evidence and suggestions are indeed confusing. The Royal College of Nursing (2008) claim that when wearing gloves a warm and moist environment is created which in turn leads to the possibility of microorganisms growing in vast numbers. Hateley (2003) reiterates this claim alongside Pratt et al (2007) who suggest that upon glove removal soap and water be used to wash hands as mentioned earlier in this text. When I was tasked with disposing of the infected waste I wanted to ensure that I did so using evidence based practice so as to minimize, if not completely eradicate, any risk of cross contamination whilst taking the waste from one area to another where the macerator was based. I was aware of the potential risk of contaminating the environment along the corridors of the ward and did not want to do this and put other patients and staff at risk therefore I needed to question my practice. The contents of the bed pan could have spilled on the floor or the paper towels which would have resulted in spores being released into the surrounding environment. I did consider using my elbow to open the door handle in the patients room and the one leading to the sluice yet came to the realization that this could have resulted in spillage onto either myself or the surrounding environment. O Callaghan (2005) stated that any challenge that nursing practice may receive could possibly add to any changes to policies and or practice regarding infection control procedures and barrier nursing. If Mohanna and Chambers (2001) is to be believed then risk management can be deemed to be an integral factor within clinical governance. Throughout this experience I did hold an awareness of the principles of barrier nursing. This led me to challenge this specific wards policies on the best practice for taking the bed pan from the patients room to the sluice. When I walked down the corridor with only paper towels covering the bed pan I was aware of the possibility that I may well have been spreading c diff spores. This could have had huge implications for all within the surrounding environment. Upon opening the door handles I was more than aware that my gloves had a high risk of being contaminated yet there was nothing I could do to eliminate this. My feelings at the time, are as they still are, ones of hypocrisy. I felt slightly shamed at the fact that I lacked the knowledge to stand and challenge the policy in a greater depth. INFLUENCING FACTORS. One of the first influencing factors of this situation was the recognition that the ward, its patients and staff were intitled to the very best of care. The NMC code of conduct (2008) state that all nursing staff have a duty of care. Within this very code it is stipulated that nursing staff hold a role that means they are expected to prevent patients from infection and protect them at all times. It also stipulates that nurses have a professional duty which includes providing evidence based practice and care that is up to date. The whole scenario was obviously one that would cause the patient to lose their dignity thereofr eI was more than aware of the need to dispose of the excreta immediately and safely. This dignity was what I was trying to protect when covering the bed pan with the paper towels, something that has been agreed as ethically right and correct practice by Timby (1996) alongside the Department of Health (2003b). Not only is this noted as being best practice within the circumstances yet also practice that would provide a reduction within the chance of spillage, therefore I was showing risk management skills. COULD I HAVE DEALT WITH THE SITUATION BETTER? In hindsight I feel that the confusion I encountered at the time of the incident could have been avoided had I had made myself aware of the wards policies on infection control and barrier nursing at the beginning of my placement. Other than this I think that I handled the situation well by questioning what I was being asked to do, however I wish I had held the knowledge that I have gained through this reflection prior to the experience. If I had then maybe I could have foreseen the situation arising and possibly found a solution to a potential problem instead of being confused by an actual problem. In addition to this one thing that I realize I did not do yet could well have done is to have used alcohol gel after washing my hands. This could have reduced the risk of cross contamination further (RCN 2008) which could have resulted in easing my concerns slightly. LEARNING. Numerous issues still remain with regards to infection control and infection prevention however this experience resulted in my awareness of the subject matter being raised. Prior to this experience I encountered I was unaware of factors that potentially predispose individuals to infection. Disease is not always caused by c diff when it is present in the bowel, it is only when bowel flora is changed from being deemed to be normal that disease occurs. This alteration of normal bowel flora can potentially be caused by specific antibiotics, a claim that has had wide spread support throughout the past twenty plus years (Lyerly et al 1988, McFarland et al 1989, Association of Medical Microbiologists 1998, DH 2007a ). Despite my actions being that of best practice within the specific trusts policy I appreciate that isolating any patient into an individual room of their own so as to decrease the risk of cross contamination. However it has to be considered that c diff spores are never truly eradicated completely from the environment. In compliance with evidence based practice guidelines (2009) I ensured that I washed my hands correctly prior to going into the patients room and also wore protective clothing. I placed two disposable paper towels over the bed pan liner due to my awareness that to get to the macerator I would have to walk down the corridor of the ward. I believe that covers for these cardboard liners should always be supplied and used. However upon searching for such a product I could not find any such thing. This is still not an idealistic solution as the risk of spillage would still remain therefore in an ideal world, as suggested earlier, all patients should have their own toileting facilities. So as to resolve the confusion of opening door handles with gloves that pose the risk of contamination it could be suggested that doors within ward environments be handle free. This would limit the contamination risk however the handle on the macerator would also need to be redesigned so as to enable that t oo to be touch free, from hands at least. This suggestion is something that the Department of Health (2008) could be argued to support due to the fact that they claimed to be researching touch free designs for specific equipment. Hand washing and protective clothing can be deemed to be a priority within the spread of c diff yet from the research and literature reviewed within this assignment it is clear that some confusion is apparent, probably steming from the noted contradictions. This experience of a critical incident enthused reflection as explored by the use of Carpers (1978) methods and ways of knowing, namely personal, ethical, aesthetic and empirical. The thorough acknowledgement of these patterns is claimed to expand not only the bredth of understanding yet also the expansion of personal thinking beyond specific approaches (Ashburner 1996). Upon placing paper towels over the bed pan the patients dignity and privacy was maintained, alongside professionalism being shown. Factors that are not only thoughtful yet also a part of the NMCs code (2008). Throughout the experience I was led by the theoretical knowledge that I had gained throughout the journey of my life. Moral decision making is said to be solely focused upon what should actually be done within a specific scenario or situation (Davis 1995). Prior to my reflection upon this practice I was not fully aware of the rational for my actions and the theory that underpinned it however I acted as I did through, as stated above, my knowledge and moral decision making. Using the reflection model of Johns (1990) guided me through an exploration of numerous and varied differing knowledge sources that led my individual actions. My whole level of understanding and awareness of infection control within healthcare settings has been raised which in turn will heighten my confidence within the subject matter for the future. This assignment has noted differing cultures within ward settings and policies that lead to contradictions and often confusion. Despite this numerous attributes that I personally hold have been credited and become aware to myself; including critical thinking and problem solving which has allowed me to explore a thought process that led to alternatives to current practice being explored. One of arguably the most important realizations I have gained from this reflection upon practice is that healthcare workers within any setting all play a part within infection control. It has been suggested that hand hygiene, namely hand washing, prior to dealing with any patient and again afterwards is at the heart of infection control (Storr et al 2005). Alongside this and the previously mentioned infection control procedures I believe that the policies and their appliance within day to day practice is indeed the key. Despite all my fore mentioned research into this subject I am left wondering and concerned that even if all staff members follow their specific policies, due to confusion within the literature a risk of cross contamination, resulting in the spread of c diff, will still be present.