Friday, May 22, 2020

The Pig Skin History and Development of American Football

The Pig Skin While Walter Camp, the father of American football we all know and love today was established. Before the 19th century â€Å"football† referred to many number of games played on foot. Each one of these games had different rules; same were played solely using your hands and were a running game. Yet others forbid the use of the hands and were kicking games. Many football historians place the games beginning in rugby which began in 1823, due to its many similarities. One of the legends is that football was invented when Englishmen playing rugby grew tired of not being able to use their hands, so they picked up the ball and ran. Then in an endeavor to enforce the rules another player tackled the man who picked up the ball. Although we didn’t aren’t sure if this is true we do know that a variation of English rugby was taking off in Canada which later became Canadian football. This is important because it had a huge influence on developing American footbal l (Saperecom). There has always been a controversy of the first American football team, but most analysts say it was a Boston Club founded in 1861, called Oneida Football Club. Even though no one knows the rules or regulations they followed. It’s not until Rutgers versus Princeton game in 1869, that we are given a glimpse of the sports early years. At this time there were 25 players on a team. Each team was made up of 11 â€Å"fielders†, 12 â€Å"bulldogs†, and 2 â€Å"planters† whose job was to wait by the other teams unguardedShow MoreRelatedSegregation in the 1970s1580 Words   |  7 Pagespredetermined by skin color. Visualize a world in which nuances of skin color are used to divide people amongst two factions: White or Black. Envision a society segregated. Whites and Blacks tossed into two different worlds, as if mankind is a pile of dirty laundry which needs to be organized by color. The reality is this hypothetical world did in fact exist in the United States prior to the 1970s. Racial segregation is a vastly recognized branch of social stratification in American history. JeannetteRead MorePopular Culture and Violent Behavior Essay11795 Words   |  48 PagesI aim to highlight revealing studies which prove the connection in my hypothesis and also the counter arguments which give evidence against that of research which proves the link between violence and popular culture . A Brief History of Popular culture Historically (until the 19th century, at least) the term popular was quite a negative expression, with overtones of vulgarity and triviality. It was something not nice or respectable. In the modern worldRead MoreAmerican Slang Essay 115481 Words   |  62 Pagespaper is to define slang in general and show some specific features of American slang. American slang lives in the specialized media of the young, such as CD booklets, songs and video clips, magazines and Web sites. Through the media, young people enter fan communities where they learn to incorporate certain forms of English into both their speech and writing to show that they’re a part of youth culture. As a result, American slang and related resources have become a global code for youth worldwideRead MoreAutobilography of Zlatan Ibrahimovic116934 Words   |  468 Pagesknow. I was the second most expensive transfer in history, and the papers kept saying I was a problem child and had issues with my personality, all kinds of bullshit, and unfortunately I felt the weight of it all - in Barca we don t stick out, and I guess I wanted to show that I could fit in. It was the most stupid decision of my entire life. I was still killing on the field. But it wasn t as fun anymore. I even thought about quitting football. Not that I would break my contract, I m a professionalRead MoreExploring Corporate Strategy - Case164366 Words   |  658 Pages– how can small players survive changing markets? Amazon (B) – latest developments in a successful dot.com. Formula One – developing the capabilities for competitive success in a hi-tech industry. Manchester United – clash of expectations in the football world. Salvation Army – strategic challenges for a global not-for-profit organisation with a mission. Bayer MS – corporate social responsibility in the international development of a German company. Eurotunnel – clash of cultures threatens to derailRead MoreLogical Reasoning189930 Words   |  760 PagesLogical Consequences and Counterexamples ..................................................... 361 3-Valued Logic................................................................................................................................ 362 History of Sentential Logic ........................................................................................................... 367 Review of Major Points ..........................................................................................Read MoreDeveloping Management Skills404131 Words   |  1617 PagesINTRODUCTION 1 3 THE CRITICAL ROLE OF MANAGEMENT SKILLS The Importance of Competent Managers 6 The Skills of Effective Managers 7 Essential Management Skills 8 What Are Management Skills? 9 Improving Management Skills 12 An Approach to Skill Development 13 Leadership and Management 16 Contents of the Book 18 Organization of the Book 19 Practice and Application 21 Diversity and Individual Differences 21 Summary 23 SUPPLEMENTARY MATERIAL 24 Diagnostic Survey and Exercises 24 Personal AssessmentRead MoreProject Mgmt296381 Words   |  1186 PagesActivity duration estimates (.3) 6.4.2 Estimating tools (.1.3.4) 6.3.1 Identifying resources 7.1 Activity cost estimates (.2.3.4.5) 5.1.2.4 Delphi method Chapter 6 10.5.3 Cost/schedule system (.1) 6.6 .2.1 Time performance 7.2.3.1 Cost baseline development 7.3.2.1 Earned value system (F.4) 7.3.2.4 E.V., performance status report 7.3.2.2 E.V., forecasts 7.3.2.3 EV., to complete index (EAC) 7.3.2.5 Schedule and cost variance Developing a Project Plan 4.2.2 Planning tools 6.2 Sequence activitiesRead MoreEssay on Fall of Asclepius95354 Words   |  382 Pagesa minute. 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Friday, May 8, 2020

A Review On Organisational Theories - 1677 Words

BUS 5113 - Assignment Unit 1 - A review of organisational theories A review of organisational theories Craig Morley University of the People A review of organisational theories 1 In Chapter 2 of the Organizational Theory text we reviewed four theoretical contributions which are central to the understanding of today s Organizations. Offer a brief analysis of all four theoretical concepts and then pick the one you the feel is the most influential from both historical and managerial perspectives. Explain. Now, consider how these concepts impacted the development of the current organizational theories. There are four schools of thought which offer a theoretical explanation of organisational task and performance: Scientific Management†¦show more content†¦Mille Bindslev, Ventus Publishing, p30 A review of organisational theories 2 model of the early 20th Century. Like Ford s industrial model, the Scientific Management School no longer holds sway in its field as a managerial ideology . 6 The Administrative Theory school, championed by Taylor s contemporary Henri Fayol shared the process-driven approach of the Scientific Management School, but instead focused on administrative efficiency . The focus was on ensuring an organisation had the 7 right structure: a top-down pyramidal hierarchy to ensure coordination, and work teams to specialise on particular activities . The model has been subject to criticisms of 8 over-simplification . For example, the emphasis on structures at the expense of ensuring 9 organisational alignment to goals. Max Weber s Bureaucracy Model encompasses a wider realm than Taylor or Fayol s models, covering social and historical perspectives, and drawing on Weber s reputation as the leading light in the field of sociology . Weber defined bureaucracy as a specific 10 administrative structure, which is based on a legal and rule-oriented authority. This 11 included many elements of Fayol s Administrative Theory, but also covers goals, means, and side-effects.12 Weber s model forms the basis of many structural analyses, covering: strategy; structure; activities and implementation; and results. In essence, structure translating and 13 mobilising the strategy . ThisShow MoreRelatedContingency Theories in Management1657 Words   |  7 Pagesvariables of organisational size, routineness of task technology, environmental uncertainty and individual differences are reflected in the work of the manager that was interviewed. Using classical theories of Fayol, Mintzberg and Katz along practical examples f rom the managers’ day-to-day routine, this essay sets out to explain how these theories and functions impact upon how the manager applies the situational approach to management using the contemporary and widely accepted contingency theories. TheRead MoreStudy Skills Assignment ( Individual Work On Organisational Behaviour1381 Words   |  6 PagesASSIGNMENT (INDIVIDUAL WORK ON ORGANISATIONAL BEHAVIOUR) â€Å"A clear purpose will unite you as you move forward, values will guide your behaviour, and goals will focus your energy.† -Kenneth H. Blanchard Organisational Behaviour has been an instrument for human development. It speaks volumes about the importance of a person as a human being and as a team member. Various theories have been put forward by researchers that support this fundamental meaning of Organisational behaviour. At the IndividualRead MoreIlm Leadership859 Words   |  4 Pages(M5.29) 5 6 Assessment criteria (the learner can) 1.1 Review the prevailing leadership styles in the organisation Assess the impact of the prevailing leadership styles on the organisation’s values and performance Level: Credit value: Learning outcomes (the learner will) 1 Understand leadership styles within an organisation 1.2 2 Be able to review effectiveness of own leadership capability and performance in meeting organisational values and goals 2.1 Assess own ability to applyRead MoreOrganisational Development And Organizational Development1604 Words   |  7 PagesThe Organisational development article I have chosen gives context to Organisational development theories from early teachings to more recent academic research highlighting disconnect among OD researchers. The OD article is from the journal of applied behavioural science. Literature review explains shortcoming among OD research. I chose the OD article for the in-depth analysis of this subject from early theories to more recent models of practice. The author discusses the implications for researchersRead MoreThe Strategic Goals Of An Organization1602 Words   |  7 PagesHR practices are the main instrument from which a company can draw on to alter the workforce as well as attempt to modify and reorganise cultural behaviours which can lead to organisational success. The behaviour, attitude and skills of employees must fit the strategic requirements of a company for it to develop a competitive advantage. However, maintaining a focus specifically on the strategic goals of an organisation has been criticised through some studies which suggest this may be detrimentalRead MoreHow Identification Communication Strategies Affect The Ways1418 Words   |  6 Pagescommunication styles affect the ways in which people create and sustain their social/communication networks. Research on organisational communication has focused on individual behavioural tendencies when they communicate with others. These behavioural tendencies are used by organisations to maintain positive relationships with their communities. Identification communication strategies in organisational communication are necessary in modern organisations and â€Å"frequent communication leads individuals to feel thatRead MoreStrategic Management and Leadership Skills1089 Words   |  5 Pagesmanagement and leadership theory to support organisational direction 3. Be able to assess leadership requirements 4. Be able to plan the development of leadership skills Assessment criteria AC 1.1 Explain the link between strategic management and leadership This assignment is a part/whole unit assessment activity AC 1.2 Analyse the impact of management and leadership styles on strategic decisions AC 1.3 Evaluate how leadership styles can be adapted to different situations AC 2.1 Review the impact that selectedRead MoreManaging People Organisations1668 Words   |  7 PagesMANAGING PEOPLE AND ORGANISATIONS | OUTCOME 3 ASSESSMENT | | Contents MANAGERIAL WORK 2 MAIN FEATURES 2 MEASURING MANAGERIAL PERFORMANCE 4 BEHAVIOURAL THEORY 5 McGREGOR, THEORY X amp; Y 5 LEADERSHIP THEORIES 6 SCOTIA EXPANSION amp; THEORIES OF LEADERSHIP 7 MANAGERIAL WORK There are three different levels of management, the first being senior level management who are concerned with the strategic planning and decision making of the organisation. The decisions they make areRead Morebusiness Assignment1024 Words   |  5 PagesBusiness Management (Part-time) BEHAVIOUR AT WORK Unit 3: Organisations and Behaviour Outcome 1: Understand the relationship between organisational structure and culture Outcome 2: Understand different approaches to management and leadership Outcome 3: Understand ways of using motivational theories in organisations Outcome 4: Understand mechanisms for developing effective teamwork in organisations SCENARIO According to Bergstram and Hamilton, organisationsRead MoreOrganizational Change : An Effective Organization1337 Words   |  6 Pageschallenges. The literature review begins with definition organisational change which defined by Van de Ven and Poole (1995) and Boddy (2011). It is crucial to take both past and today’s definition of organisational change because the business environment has been changed dramatically. Following by review on different types of resistance to change by Kotter Schlesinger and Powell Posner In fact, there are numerous types of resistance to change according to their own organisational culture in different

Wednesday, May 6, 2020

Care of the Malnourished Elderly Patient Free Essays

string(60) " of care to assist patients with improving their nutrition\." Table of Contents Page numbers Abstract†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 2 Chapter 1 / Introduction Origin of the Problem†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 5 Significance or Importance of the Problem for Nursing†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦6-8 Problem Statement†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. We will write a custom essay sample on Care of the Malnourished Elderly Patient or any similar topic only for you Order Now 8 Purpose of the Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦. 9 Hypothesis- Null and Research†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦.. 9 Definition of Terms.. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 9-10 Assumptions†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 10 Summary†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦. 10 Chapter II/Review of Literature Review of Literature†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦11-16 Chapter III/Methodology and Research Design Research Design†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 17 Variables†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦17-18 Selection of Subjects and Research Setting†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦. †¦Ã¢ € ¦. 18-19 Data Collection Instruments †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦.. †¦Ã¢â‚¬ ¦ †¦. 19 Statistical Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦. †¦. †¦. 20 Data Collection Procedure †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦. 20 Limitations†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 21 APPENDICES A. Request for Permission to Survey Participants†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦. †¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦. †¦. 22 B. Nutritional Assessment Survey†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦23-26 REFERENCES . †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦27-28 Chapter I. Introduction Origin of the Problem In our society, malnutrition and under-nutrition is a rising problem for the older adult population. Approximately 35%-85% of residents living in a long-term care facility, 60% of hospitalized older adults, and an estimate of 5%-10% of older adults living in community settings are malnourished (Maher and Eliadi, n. d. ). These statistics sadly show that hospitalized and long-term care patients are more likely to become under nourished compared to the elderly population in the community. According to the Joanna Briggs Institute (JBI, 2007), malnutrition can lead to serious or adverse health outcomes. Malnutrition has been linked to lengthy hospital stays with higher complications, morbidity, mortality, and frequent visits to their general practitioner (JBI, 2007). There are several risk factors (i. e. physical, psychosocial, social, and medical factors) that lead to malnutrition (Maher Eliadi, n. . ). It is predicted that by 2030, the elderly population in the United States will double in size and exceed 70 million people. In light of these predictions, addressing the nutritional needs of the elderly will reach epic proportions and become a complex issue. Based on clinical observation, the signs and symptoms of malnutrition and under nutrition are often overlooked. Observing residents in a clinical s etting at a local long- term health care facility precipitated our interest in this problem with malnutrition. The majority of elderly people living in care homes either have dementia, suffer from some form of physical disability, or have difficulty swallowing, which restricts them from adequately hydrating and nurturing themselves. With dementia, they usually do not remember how to eat or how to chew. With various physical disabilities, such as upper extremity contractures, their ability to feed themselves is often limited. In the event of swallowing difficulties, their food preference is often altered to prevent choking or aspiration. This often discourages them from eating due to the texture of the diet ordered. With the issues fore-stated, the residents often have to rely on the staff to assist them with meals. Caregivers often contribute to the problem of malnutrition because not enough time is devoted to assisting and supervising the residents to ensure they are eating properly. It is our job as caregivers to know the signs of malnutrition and risk factors that lead to malnutrition so that it can be detected and reported to the physician or dietitian early, before major problems occur. Various nutritional screening tools, assessment tools, studies, and research programs are available to help isolate and provide aggressive preventive treatment strategies for those at risk. The Nutritional Form for the Elderly (NUFFE), Malnutrition Screening Tool (MST), and the Malnutrition Universal Screening Tool (MUST) are instrumental in detecting and providing interventions to decrease morbidity and mortality. These various studies help support the fact that malnutrition is overlooked, unrecognized, and left untreated by nurses and healthcare professionals. Other studies find that even though malnutrition was identified, no interventions were put into place to treat this growing concern. Significance of the Problem for Nursing In a hospital based setting, there are several different groups and departments that deal with patient care. These departments and groups consist of nutritionists, doctors, social workers and other disciplines. However, the nurses are ultimately responsible for the entire care of the patient throughout their stay. Nurses realize that many elderly patients come into the hospital undernourished or malnourished related to their being on a fixed income, having reduced access to food, having poor knowledge of nutrition, or being dependent on others for food preparation. These elderly patients sometimes have chronic illness such as depression, cancer, diabetes, renal failure, and cardiovascular disease that leads to malnutrition or under- nutrition (Briggs 2007). Under-nutrition is a wide spread problem that usually results in the elderly staying in the hospital longer related to a delay in recovery, more complications, and higher mortality rate. That is why it is important for nurses to do a detailed assessment upon admission to prevent these issues or problems. It is the nurse’s responsibility to gather all the background information about a patient during the assessment period. This will help to diagnose the nutritional status from the beginning of the patient’s care. Some of the information that is collected during this time, such as the patient’s mental status, allows the nursing team to identify if the patient is oriented or has problems with dementia. According to Briggs’ 2007 article, dementia is a common cause of under nutrition, as are the adverse effects of medications, such as digoxin and some anti-depressants. Antihistamines, angiotensin-converting enzyme inhibitors, and lithium zinc deficiency can alter a patient’s taste and smell. For this reason, the nurse needs to collect a medication list that is current (Briggs 2007). During this process, nurses should ask questions that will reveal information about the patient’s medical history. This is done to identify possible diseases that have an effect on the patient’s nutritional status. Nurses should use all resources available to them after collecting data to assist with care of the patient. It is important for the nurse to know the policies and procedures at the current hospital to consult specialists in order to improve patient care. This allows each department access to review the patient’s medical information and provide patient care as needed. Nurses are the primary caregivers for elderly patients in the hospital. When a malnourished patient is admitted nurses often develop plans of care to assist patients with improving their nutrition. You read "Care of the Malnourished Elderly Patient" in category "Papers" Some of the ways that have been recommended are serving food at the appropriate temperature, providing food that is packed with nutrients, offering food that the patient enjoys eating, and giving oral supplements throughout the day to increase caloric intake. A good tip that nurses could use would be to always offer food or drinks when entering the patient’s room. From this research we know that poverty is one reason for malnutrition. When developing a plan of care for this patient the nurses can solicit the help of a social worker to help find resources to save money and provide food (Mayo Clinic, 2011). Malnutrition is a significant problem in nursing because it alters the type of care a nurse can provide. For instance, if a wound already exists, malnourished patients are at a higher risk for decreased wound healing. The nurse will then have to improve the nutritional status before proper wound healing can occur. The malnourished individual can become very weak and is thereby prone to falls. The impoverished elderly patient may not only be malnourished but have insufficient funds to purchase needed supplies, such as diabetic test strips and glucose monitoring systems. This could also lead to weakness and the development of further complications. Nurses need to ensure that daily weights and labs are obtained to track the progress of each patient. Malnutrition may seem secondary in nature, but it can grow into a monumental problem. Problem Statement Do registered nurses use evidence-based standards in the care of elderly hospitalized patients who are undernourished? Purpose of Study The purpose of this study is to examine registered nurses usage of evidence-based standards in the care of undernourished elderly hospitalized patients. Hypothesis Research Hypothesis: Registered nurses use evidence-based standards in the care of undernourished elderly hospitalized patients. Null Hypothesis: Registered nurses do not use evidence-based standards in the care of undernourished elderly hospitalized patients. Definition of Terms For the purpose of this study, the following terms have been defined: 1. Undernourished- defined as an imbalance of nutrients caused by either an excess intake of nutrients or a nutritional deficit. (Maher Eliadi, n. d. ) 2. Older Adults- Age 64 or older. Maher Eliadi, n. d. ) 3. Associate Degree Registered Nurse- Registered nurses (RN’s) provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members. Registered nurses must also become licensed by passing a national licensing examination. An associate degree is an academic degree awarded on satisfactory completion of a 2-ye ar course of study, usually at a junior college. (Bureau of Labor Statistics, 2012) (Elsevier, 2009) 4. Evidence-Based Practice- the use of scientific evidence, integrated with clinical experience and incorporating patient values and preferences in the practice of professional nursing care. (Houser, 2012, p. 12) 5. Hospital Setting- a health care facility that provides inpatient beds, continuous nursing services, and an organized medical staff. (Elsevier, 2009) Assumptions 1. If caregivers feed elderly patients, then the proper amount of the meal will be consumed. 2. Registered nurses help to prevent malnutrition in elderly patients. 3. The adequate amount of protein consumed in an elderly patient’s diet prevents malnourishment. . Registered nurses provide help with dietary interventions of the undernourished. 5. If the proper screening tools are performed on admission, the elderly patient’s weight will improve. Summary People in this nation are living longer. As recognized throughout this research, malnutrition in the elderly patient is at an extremely high level. It is not only the nursing home patients experiencing undernourishment but the hospitalized elderly patients also. Malnutrition is prevalent throughout the elderly community. Through using evidence based practice tandards, malnutrition tools, and education strategies this dilemma can be improved. CHAPTER II. Review of the Literature Undernourishment has long been a prevalent problem among the elderly, especially in an acute-care setting. It has been a long-standing challenge for health-care providers to determine the most effective process for identifying those that are undernourished, at-risk for undernourishment, as well as intervening promptly and appropriately. A review of literature was done to examine registered nurses usage of evidence-based standards in the care of undernourished elderly hospitalized patients. Much of the literature supports the use of nutritional screenings to identify undernourished patients and reduce the number of those patients in the hospital setting. Undernourishment is often referred to as malnutrition. The effects of malnutrition, which is the inadequate consumption of essential nutrients, are very devastating to the health of an individual. As well-known among healthcare providers, inadequate nutrition can prolong wound healing, suppress the immune system, lead to increased length-of-stay, and increase the risk of mortality from comorbidities. The article entitled, â€Å"How well do nurses recognize malnutrition in elderly patients,† describes how well nurses are able to recognize the problem of undernourished patients and if care is being provided to these patients. There are numerous methods that can be used in determining if a patient is malnourished. In this study Mini Nutritional Assessment (MNA), Body Mass Index (BMI), and a detailed questionnaire was used. The MNA is a simple, reliable, and well-validated tool used to determine a patient’s nutritional status. MNA gives a maximum of 30 points. A score of less than 17 indicates the patient is undernourished, while a MNA of 17-23. 5 shows a patient is at risk for malnutrition. BMI is another tool used in determining the status of a patient’s nutritional state. In this study a BMI of less than 20 is considered to be high risk for malnutrition. A questionnaire was given to nurses to determine daily routines related to nutritional care such as amount of food consumed at each meal, snacks between meals, and any oral nutritional supplements given. The study examined elderly patients in a long-term care unit in Helsinki City hospitals in Finland to determine if nurses are able to recognize undernourished patients and if adequate care was provided (Suominen, Sandelin, Soini, Pitkala, 2009). The above study included 1,043 elderly hospitalized patients for a two-week period. The nurses measured the BMI of patients as well as their MNA, but the nurses were not aware of the values to determine an undernourished state. In addition, the nurses were asked if they believed the patients were malnourished by simply marking yes or no. The nurses that performed the study participated in a 3-hour course to learn how to organize the study, assess the patients, and to complete the questionnaire (Suominen et al,. 2009). The results of the study, â€Å"How well do nurses recognize malnutrition in elderly patients,† revealed that malnutrition is not recognized by nurses and therefore results in the inability to provide evidence-based care to the patients. The results showed that 56. 7% were malnourished with an MNA How to cite Care of the Malnourished Elderly Patient, Papers