Management of change Essay Example | Topics and Well Written Essays - 4250 words

Management of change - Essay Example The rationale for this study, as well as the summary of the literature findings shall also be set forth. The change proposal shall then be laid out and the steps in the implementation process shall also be explained based on the change management framework developed by Lewin. Based on the Nursing and Midwifery Council (NMC, 2008), a nurse is obligated to deliver the best and the highest standard of care at all times. More specifically, they are called on to deliver care, according to the best available evidence and best practice; and they must also ensure that the advice they are giving to their patient, in terms of healthcare products and services, is based on evidence (NMC, 2008). There are numerous evidences which are often made available to nurses for use in their practice. For which reason, it is important for nurses to be knowledgeable and skilled in the critical evaluation of evidence and ensure that the evidence they would choose to support and apply in their practice would b e the best (Spector, 2007, p. 1). For the purpose of this essay, the definition of evidence-based practice by Sackett, Straus, Richardson, Rosenberg, and Haynes shall be adapted. They define the practice as â€Å"the integration of best research evidence with clinical expertise and patient values† (Sackett, Straus, Richardson, Rosenberg, and Haynes, 2000, p. 71). ... based practice therefore considers the role of the patient in the planning and conceptualisation of their care (Pipe, Wellik, Buchda, Hansen, and Martin, 2005). The nurses have to include and consider patient preferences in relation to the best evidence available and apply such to the planning process. Critics like Mullen and Streiner, however, are not supportive of EBP, contending that it prevents the application of the most effective treatment for the patient. They point out that EBP does not â€Å"fit the realities of individualised, contextualized practice, especially nonmedical practice wherein problems are less well defined (Mullen and Streiner, 2004, p. 133). They also emphasised that there are often many limitations in the methods of research in the systematic reviews and meta-analysis. Moreover, concern has been expressed on how evidence-based research can be conceptualised when competing elements like public opinion and resource limitations affect policy-making (Mullen and Streiner, 2004, p. 133). On the other hand, health practitioners are quick to point out that EBP is about being guided by the best available evidence. This means that absent available randomised controlled trials without design flaws, trials which have limitations can be used instead (Mullen and Streiner, 2004, p. 133). In effect, health practitioners and users of health services must be cautious about the risks and benefits when the evidence for decisions are made apparent, even if this would mean that there is not much evidence supporting the different choices (Mullen and Streiner, 2004, p. 133). Proponents of EBP also point out that even as the realities of practice may be far removed from the behaviour and practical aspects of the clinical practice, there is merit in considering the

Do countries that vote against the US trade less with the US Essay

Do countries that vote against the US trade less with the US - Essay Example International organizations are meant to make use of democratic procedures in all their decision making since they obtain their legitimacy from the countries they govern. However, the UN appears not to base all its operations on this tenet. This is primarily based on the hypothesis that super countries such as the US use their economic, as well as political might to persuade less superior countries to favor them in their voting endeavors. Varied studies have identified links between UN voting and financial aid from national and institutional donors. One of the most vital studies found that aid from multilateral donors such as the World Bank and the IMF is determined to a significant extent by countries that make major contributions to these institutions (Oatley and Yackee 416). Therefore, in addition to influencing the flow of their own donations, rich countries such as the US also influence the flow of aid from international donor organizations. Notably, so as to enhance its buy-in of significant powers, the US incorporates in its voting strategies, among others, deviations from majority rule, for instance, through weighted voting and consensus norms in global financial powerhouses such as the International Monetary Fund (IMF) and at the World Trade Organization (WTO). A vast majority of international organizations are renowned for their deviations from democratic voting, for instance, through induced voting on account of adverse implications associated with going against countries such as the US. The US is known to make use of its direct, as well as indirect links, to sway voters to vote in their proposals or requirements at the UNGA. The voting strategies employed by the US at the UN are linked to bilateral international aid with global institutions such as the IMF and World Bank. This is implicit of the fact that elements such as financial aid and trade relations are used to corrupt the process of voting at the UNGA (Oatley and Yackee 417). The corrupt proc ess of indirectly buying votes entices countries such as Syria, Saudi Arabia and Iran into voting for the US rather than against it at the United Nations General Assembly. Scholars who have long examined the US Congress poise that the US uses campaign contributions, as well as other special financial endowments, to influence the voting tendencies of other countries at the UN. Economically endowed countries such as the US both purchase votes and offer financial and political assistance to friendly regimes, particularly in countries that have long experienced political strife, for instance, Syria and Iran. The foreign trade and global economic policies of the US have significantly altered trend in the course of the more than two centuries that the US has been a sovereign country. In the early years of the country’s history, the government and business environment focused intently on the development of the domestic economy regardless of the occurrences in other countries. Howeve r, since the Second World War and the 1930s Great Depression, the US has generally endeavored to coordinate the global economic system and reduce trade barriers (Oatley and Yackee 419). The US’ commitment to free trade has been rooted both in political and economic factors. For instance, the US has increasingly considered open trade as the means through which it can advance its own economic