Code of Ethics Sustainable Business Communities

Question: Describe about the Code of Ethics for Sustainable Business Communities. Answer: 1: As a Civil Engineer and that too at a higher level in the organisations hierarchy I am fully aware that the professional Code of conduct. In analysis the Samarco disaster the first thing that strikes that all the areas of ethical conduct as required under the engineering profession. To quickly recapitulate the entire disaster it is found that with the falling prices of Iron Ore pellets in the market the company started stepping up its production. Now higher production meant higher generation of waste materials. While the retaining capacity of the waste material remained a constraint the company decided to raise the height of the dams holding the slurry waste. Despite the warning from the original designer about the raised walls being precariously placed and cracks having shown up in many places in the dam the organisation decided to play down the danger and the dam eventually gave way(Mackenzie, 2016). The damage was extensive and the worst part of the entire scene is that the company is trying to find out the culprit instead of giving priority to rehabilitation of the people whose properties have been damaged. Now the individual aspects of the ethical code of conduct will be taken up for discussion and it will soon be evident that the catastrophic condition would have struck sooner or later. Demonstrate Integrity: The mining company has consistently projected a picture to the people and the administration including the police that there was no cause for worry and every aspect of the mining activities were safe and secure. They knew very well that that the dams holding the waste sludge was not designed for accommodating the volume that was being generated(Smith, 2013). Practise Competently: Professional competence is very highly questionable here since apart from the very insecure condition of the dam the quality of the sludge it held was highly toxic and they had not taken the steps for treating the sludge for toxicity as would be expected from a competent engineer. The damage to the flora and fauna in the path of the slurrys travel indicates that professional competence is highly questionable(engineersaustralia, 2010). Exercise Leadership: The organisation failed to show concern for their people. When people were suffering so very acutely this company chief executive is constantly talking about finding out the reasons for this disaster. They were directly undermining the urgency about the need to rehabilitate the people and clear the mess created by the failing of the dam. The basic fault was in trying to serve the interests of the shareholders raising the production level without taking precaution to protect the interests of other stakeholders like the employees, the community and the environment(Gahan, et al., 2016). Promote Sustainability: Their actions very clearly manifest their very scant concern for the sustainability. They did a very shabby work of storing their mining waste when they should have taken much greater care to ensure that all danger zones are suitably looked into and problems addressed(Burke, 2011). 2: There are very clearly laid down rules for treatment of wastes, both from industries as well for mines, that before he wastes are released to the environment they should be treated adequately so that the damage done to the environment is controlled. The extent of strictness and coverage of these rules keep changing as time passes(Bagley, 2011). Now, in the extraction of Iron Ore from its deposits the generation of fines, undersize and earth content cannot be eliminated. Rules are very clear about the release of the waste products into the nature and they cannot be changed. Further, there may be some temporary benefits, mainly for the investors in flouting the rules but that cannot go on for all time(Griggs, Clarke, Iredale, 2009). Hence the first and foremost thing is to ensure that the working of the organisation does not violate the rules and at the same time act in a manner which is in compliance with the ethical demand of the profession. Compliance to rules is only the tip of the iceberg; the main idea is to ensure that the interests of all the stakeholders are attended to without neglecting the need of any stakeholder. The proposal is to put in place a system of treating the wastes so that they are harmless to the nature. The toxicity and acid content of the waste matter should not harm the flora and fauna of the land. This obviously is easier said than done since the process may involve a tidy investment towards the establishment of the waste treatment facility. While the organisation had in the past given the lowest priority to handling the waste matter it is now time to wake up to the fact that while by storing the waste products near the site of excavation may be legally tenable but ethically it stands on the way of professional engineers ethics. As engineers we have to behave more responsibly and ensure that none of our actions led to any legal or ethical violations in the long run(coursehero, 2014). While treating the waste generated is a certain way of being responsible for the well being of the community, another way would be to sell off the waste materials in the world market. The colour of the sludge that is shown flowing in the link indicates that the sludge contains a reasonably high content of iron ore. This is construed on seeing the colour which is dark red and has the colour of low grade iron ore. There are many steel plants in the world who may take away the waste material for use at their end after refining and washing. This company should not get constrained by the price it fetches it should be prepared to dispose of the waste materials at the rock bottom price. Whatever is not as a price is a bonus since thereby they save on the costs of treating the waste products. If there are no takers available, then this company should get rid of the materials without charging anything since that would enable them to avoid the expenditure involved in building dams and treatments. In this way both ethical as well as the legal requirements are fulfilled. 3: In Australia the laws pertaining to contracts are largely products of common law and have been evolved by the courts and are not generally passed by the parliament. A fundamental principle followed by common law is that all contracts are essentially bargains which have been made freely between parties who have equal say or power in executing the contract. The basic premise is that there is total and full freedom given to the parties in working out and finalising any contract. In the present day, however, the buyer and seller do not have equal power(Fairhall, 2012). The seller is usually a large business house with immense clout in the government and judiciary while the common man has to choose between take it or Leave it options(Quilter, 2014). Acceptance of an offer must be concluded with an agreement between two parties. After successfully compilation of the agreement, both the parties are legally bound to each other. Each party will be giving some consideration about the agreement for promise to do, or not do. There must be a legal opportunity to enter into an agreement or into the contract for both the parties. Every contract has some legal and unique requirements; like selling of land must be in writing. Consent to the agreement should be unique for each parties. Only those person who are into the agreement, can only enforce the particular contract. Finally the legality of contract describes that the purpose of the agreement is contrary to law and that can not be enforced by the court. Now, this case of the sportsman purchasing the automobile from this company who despite being told categorically by the sales person that the car can travel on its own pretty well but the driver of the vehicle must always be prepared to take over the control since there was no better way to travel than by ensuring safety by manual control when needed. Thus prima facie this company has delivered a vehicle which can generally travel on its own but the travelling should be ensured under the alert eyes of the driver. The customer did not heed the advice of the sales person and he did not even go through the details of the conditions of sale while signing the purchase contract. Judged by these facts the company is in a very sound position and there is not much cause for worry in this regard(Zetler, 2011). However, the main source of concern for this company is the revelation that the failure of the engineer to locate a technical fault. As per the case study the fault of the Self-Drive mode of the car has been acknowledged by BC due to human error by an engineer during the wiring, which led to the crash. This is the prime area of concern and the management must own up the responsibility for the failure which was due to a technical fault. As per the requirements of engineering ethics he engineer had not acted responsibly since his lapse in locating the loose wiring cost the customer dearly. Since their actions affect the people who use the cars the engineer should have taken the time for checking the circuit and ascertaining that it was technically perfect(Wilson, 2016). This might have meant a lower production figure for the day yet whatever number of cars would have come out that particular day would have been fit for use without causing an accident. This is to recommend to the management that while the commercial implications are important for every engineer the management must create a culture where the ethical aspect is given its due recognition and importance. This ethical stand should have been ensured and encouraged by the top management. Let us recollect the old saying The neck of the bottle is always at the top. References: Bagley, E. (2011). Managers and the Legal Environment: Strategies for the 21st Century; https://books.google.co.in/books?id=3eIJAAAAQBAJprintsec=frontcoverdq=L+Griggs,+E+Clarke+and+I+Iredale,+Manager+and+the+Law,+3rd+ed,+Lawbook+Co+Thompson+Reuters,+2009,+p+15.hl=ensa=X. Burke, T. (2011). Sustainable Australia Sustainable Communities. Retrieved August 31, 2016, from environment: https://www.environment.gov.au/system/files/resources/6944262c-e3de-4b70-9e09-e3e75668ce63/files/population-strategy.pdf coursehero. (2014, August 29). Managers and the legal environment Introduction. Retrieved August 31, 2016, from coursehero: https://www.coursehero.com/tutors-problems/Law/8607197-Further-instructions-to-students-This-ass/ engineersaustralia. (2010, July 28). Code of Ethics. Retrieved August 30, 2016, from engineersaustralia: https://www.engineersaustralia.org.au//sites/default/files/shado/About%20Us/Overview/Governance/codeofethics2010.pdf Fairhall, H. (2012, July). Australian Government Review of Australian Contract Law. Retrieved August 30, 2016, from lawsociety: https://www.lawsociety.com.au/cs/groups/public/documents/internetyounglawyers/644777.pdf Gahan, P., Adamovic, M., Bevitt, A., Harley, B., Healy, J., Olsen, J., et al. (2016). Leadership at Work: Do Australian leaders have what it takes?: https://sal.workplaceleadership.com.au/sites/default/files/inline-files/SAL-Report.pdf. Griggs, L., Clarke, E., Iredale, I. (2009). Manager and the law. Sydney: Lawbook Co Thompson Reuters. Mackenzie, A. (2016, March 04). CATASTROPHIC FAILURE. Retrieved August 31, 2016, from ABC: https://www.abc.net.au/4corners/stories/2016/02/29/4413666.htm Quilter, M. (2014, Octobor 01). The Law Handbook. Retrieved August 31, 2016, from legalanswers: https://www.legalanswers.sl.nsw.gov.au/guides/law_handbook/pdf/Ch12_contracts.pdf Smith, T. (2013, September 12). 16 Ways to Demonstrate Integrity. Retrieved August 30, 2016, from insightsfromanalytics: https://www.insightsfromanalytics.com/blog/bid/332218/16-Ways-to-Demonstrate-Integrity Wilson, . (2016). Codifying Contract Law: International and Consumer Law Perspectives; https://books.google.co.in/books?isbn=1317164822. Sydney. Zetler, J. (2011, Feb). MARKETING AND MANAGEMENT LAW . Retrieved August 31, 2016, from businessandeconomicsc: https://www.businessandeconomics.mq.edu.au/current_students/undergraduate/resources/unit_outlines_summary/ug/2011/buslaw/BUSL350_Marketing_and_Management_Law_2011_S2.pdf

How to Make an APA Citation Sample

How to Make an APA Citation SampleIf you are a student who is going to write a dissertation, you will have to learn how to make an APA citation sample. There are many things that you need to do when writing your essay, but the use of a citation sample will definitely help you out. This will be the first time that you see what an actual APA citation is like.When you begin to write an essay for an APA test, you will have to use citations. These are the most commonly used format of a typical reference work. In fact, most students find it helpful to have this template with them. You will find that you can have the essay easily printed, or you can photocopy this template so that you can take the same thing to the library and have it written out for you.Even though you can print out this example essay, you can even save it to your computer for a more in-depth explanation. Although the textbook you are using to write your own essay will contain a citation, it may not be as clear as what you will see with this sample. This is why you should photocopy it and take it to the library for a little extra instruction. Of course, this template is made for the APA version, but there are some guidelines that you can follow to make sure that you are using the right one.For the beginning reference writers, you may find that the referencing format they are using isn't that accurate. While the citation sample is done in such a way that it is easy to understand, the ideas behind it are just as important. And while you may find that the method you are using is the correct one, it will still take a bit of work on your part to make it effective.The great thing about this guideline is that it can help you do exactly that. While you cannot copy it word for word, you will have all the details in one place and can create your own template that is unique. You can also change it a little bit from the format you want and make it yours, based on what you are going to write.When you are writing your own essay, the sample is perfect for you to refer to at any time. It will be the right method for you to follow, and you won't have to worry about wasting time copying something down. Once you begin to write your own paper, this template will always be there. This is the guide you will be using.As you have learned by now, the online sample comes from the APA, and it is very detailed. You will find that if you make a copy of it, you can continue to update it and improve it for years to come.

The Scarlet Letter Reference to Mirrors Essay Example For Students

The Scarlet Letter: Reference to Mirrors Essay Darci FordMrs. HortonEnglish III-APMonday, January 18, 1999Nathaniel Hawthorne has a sufficient reason for repeatedly making reference to mirrorsthroughout his refined novel, The Scarlet Letter. The use of mirrors in the story serve a beneficialpurpose of giving the reader a window to the characters soul. The truth is always portrayed inthe authors mirrors; thus, his introspective devices will continuously point out the flaws to whomgazes in it. Hesters A has now become the most noticeable part of not only her physicalfeatures, but her spiritual being. The reflection of Pearl Prynne uncovers her hard shell and bringsout the loneliness, the innocent recklessness, and the wild beauty within her. ReverendDimesdales image only radiates the dark, gloomy truth of his impurities. The looking glassNathaniel Hawthorne places in front of his characters, therefore, focuses on the realms that eachbeholder attempts to hide from the world around them. In chapter two while Hester is standing on the scaffold, she tries to run from reality byreminiscing of her youth. At that moment, she saw her own face, glowing with girlish beauty,and illuminating all the interior of the dusky mirror in which she had been wont to gaze at it. Sadly, the mirror will never again give Hester that immaculate reflection. Instead, the image willalways resemble that of the breastplate at the governors mansion in chapter seven, owing to thepeculiar effect of this convex mirror, the scarlet letter was represented in exaggerated andgigantic proportions, so as to be greatly the most prominent feature to her appearance. Ironically, the two symbols of her sin and suffering, the scarlet letter and Pearl, are now the mostsignificant elements of her life. Hester is no longer looked at as a woman in society, and in themirror, she seemed absolutely hidden behind it (the scarlet letter). As for her child, that lookof naughty merriment was likewise reflected in the mirror, with so much breadth and intensity ofeffe ct, that it made Hester Prynne feel as if it could not be the image of her own child, but of animp who was seeking to mold itself into Pearls shape. Pearls mischievous looks are magnifiedin the mirroring surface to remind Hester that her child is in fact a part of the punishment of hersin. Once this freakish, elvish cast came into the childs eyes while Hester was looking at herown image in them. . . . she fancied that she beheld, not her own miniature portrait, but anotherface, in the small black mirror of Pearls eye. It was a face, fiendlike, full of smiling malice, yetbearing the resemblance of features that she had known full well, through seldom with a smile,and never with malice in them. This is another indicator in chapter six that Pearls presencedoes in fact haunt Hester. It also speaks the truth that Roger Chillingworth is not the same manhe once was, and Hester will continue to be haunted by him also. Nathaniel Hawthornes use of mirrors plays a crucial part in portraying th e hidden side ofPearl Prynne. Though Pearl has a reputation to be of witchcraft and gives the reader animpression of being a brat, the child has a very fragile and endearing soul that wanders on theother side of the mirroring surface. In chapter fourteen by the ocean, Pearl came to a full stop,and peeped curiously into a pool, left by the retiring tide as a mirror for Pearl to see her face in. Forth peeped at her, out of the pool, with dark glistening curls around her head and an elf-smilein her eyes, the image of a little maid, whom Pearl, having no other playmate, invited to take herhand and run a race with her. The reflecting pool portrays Pearl as an innocent and beautifulchild who is very lonely. That is very understandable, for Pearl is not like the other children; heronly two friends are nature and her mother, Hester. In chapter fifteen, Pearl flirted fancifullywith her own image in a pool of water, beckoning the phantom forth, andas it declinedventureseeking a passage for he rself into its sphere of impalpable earth and unattainable sky. Soon finding however, that either she or the image was unreal, she turned elsewhere for betterpastime. Pearls reflection is very real, and chapter sixteen smoothly continues this concept throughanother body of waterthe brook in the forest. Pearl resembled the brook, inasmuch as thecurrent of her life gushed from. . . . like the voice of a young child that was spending its infancywithout playfulness, and knew not how to be merry among sad acquaintance and events ofsomber hue. As interpreted through the description of the brook, Pearl lacked many simpleencumbrances growing up, and therefore, lacks sympathy and emotions that numerous individualstake for granted. In chapter nineteen, Pearls alliance to nature is clearly shown as the brookchanced to form a pool, so smooth and quiet that it reflected a perfect image of her little figure,with all the brilliant picturesqueness of her beauty, in its adornment of flowers and wrea thedfoliage, but more refined and spiritualized than the reality. Nathaniel Hawthorne was wise touse the forest brook in relation to Pearl, for she is untamed like the forest. Branching from thatwild gift within Pearl, the wrath she is compelled to carry is also lustered through the brook thatflows beneath her. Seen in the brook, once more, was the shadowy wrath of Pearls image,crowned and girdled with flowers, but stamping its foot, wildly gesticulating, and, in the midst ofit all, still pointing its small forefinger at Hesters bosom! The speculum reveals the hard truththat Pearl is a part of the scarlet letter, and that she feels emotionally nonexistent when sherealizes her mother had abandoned the emblem on the ground. The weak mortality of Reverend Dimesdale is also depicted by Nathaniel Hawthornesexercise of mirrors throughout the novel. In chapter eleven, Arthur is desperate to flush away hissins and absorb righteousness back into his soul. He kept vigils, likewise, night afte r night. . . . .uae482822879879fcb15a4189b714e051 , .uae482822879879fcb15a4189b714e051 .postImageUrl , .uae482822879879fcb15a4189b714e051 .centered-text-area { min-height: 80px; position: relative; } .uae482822879879fcb15a4189b714e051 , .uae482822879879fcb15a4189b714e051:hover , .uae482822879879fcb15a4189b714e051:visited , .uae482822879879fcb15a4189b714e051:active { border:0!important; } .uae482822879879fcb15a4189b714e051 .clearfix:after { content: ""; display: table; clear: both; } .uae482822879879fcb15a4189b714e051 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .uae482822879879fcb15a4189b714e051:active , .uae482822879879fcb15a4189b714e051:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .uae482822879879fcb15a4189b714e051 .centered-text-area { width: 100%; position: relative ; } .uae482822879879fcb15a4189b714e051 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .uae482822879879fcb15a4189b714e051 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .uae482822879879fcb15a4189b714e051 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .uae482822879879fcb15a4189b714e051:hover .ctaButton { background-color: #34495E!important; } .uae482822879879fcb15a4189b714e051 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .uae482822879879fcb15a4189b714e051 .uae482822879879fcb15a4189b714e051-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .uae482822879879fcb15a4189b714e051:after { content: ""; display: block; clear: both; } READ: Good Ancestors Like Dandelions Essay We will write a custom essay on The Scarlet Letter: Reference to Mirrors specifically for you for only $16.38 $13.9/page Order now sometimes, viewing his own face in a looking glass, by the most powerful light which he couldthrow upon it. Unfortunately, Nathaniel Hawthornes mirrors show no mercy. He thustypified the constant introspection wherewith he tortured, but could not purify, himself. Littledoes Arthur know that the looking glass is only functions as a tool to represent truth, and inactuality, the reverend is not acquitted of his sins. The very limited light that shines onto thelooking glass is used to burn deep into the ministers soul, grasp the shameful secret he hideswithin his heart, and shine the consequences back in his face over and over again. In theselengthened vigils, his brain often reeled and visions seemed to flit before him perhaps seendoubtfully, and by a faint light of their own, in the remote dimness of the chamber, or morevividly, and close beside him, within the looking glass. Reverend Dimesdale tried to overcomethese ghastly images, but he couldnt fight the fact that they were, in one sense, the truest andmost substantial things which the poor minister now dealt with. The looking glass franklyreveals that Reverend Dimesdales existence now relies on the anguish in his inmost soul. Within The Scarlet Letter, Nathaniel Hawthorne analyzes his main characters distinctionsthrough his use of mirrors. By using this device of imagery, the reader of the novel can easilygrasp Nathaniel Hawthornes dark opinions of the world, man, society and their relationships toeach other. Most importantly, the author wants to exhibit to the reader the close relationshipbetween good and evil, and the importance in telling the truth under all circumstances. NathanielHawthorne has done a wonderful job in this piece of literature by referring to mirrors as a tool todig into the truth of the human heart.

Free Essays on Bastard Out Of Carolina

The Merriam-Webster Dictionary defines moral as â€Å"conforming to a standard of right behavior and or being capable of right and wrong action† (481). Yet who is to say what actions are perceived as either right or wrong? Is someone who discovers that too little was taken out of his or her paycheck for federal taxes an immoral person just because they do not report it? A percentage of people would answer yes to this question, while others would disagree and say that â€Å"they caught a break†. Some people would say that a woman who has an abortion is immoral, while others would contend that it is her right to choose. These are just a few examples of how people’s opinions can differ on what it is right and wrong. Yet most people can agree that the behavior exhibited by characters in Dorothy Allison’s Bastard Out of Carolina, can at best be described as questionable. The character whose morals are obviously the most twisted, so much so that he comes across as malicious and evil, is Glen Waddell. He constantly lets his temper get the best of him, causing violent outbursts in the workplace that cost him numerous jobs. However, this is nothing compared to the mental and physical torment that he inflicts on Bone. He starts this method of abuse by sexually molesting Bone when she is nine years old in the parking lot of the hospital where her mother is giving birth (46-47). It then escalates into his constantly telling her that she is good for nothing and beating her for the most minor infractions (234). After years of this abuse the violence comes to its peak with a horrifying and brutal rape in which he tells Bone that he prayed for her to die and he would kill her if Anney did not come back to him (283). Anyone who can say that this is a man of sound mind should be locked in a cell along with him. Another character in the novel whose morals seem unintelligible is Bone’s mother Anney Boatwright. The ambiguity of her mora... Free Essays on Bastard Out Of Carolina Free Essays on Bastard Out Of Carolina The Merriam-Webster Dictionary defines moral as â€Å"conforming to a standard of right behavior and or being capable of right and wrong action† (481). Yet who is to say what actions are perceived as either right or wrong? Is someone who discovers that too little was taken out of his or her paycheck for federal taxes an immoral person just because they do not report it? A percentage of people would answer yes to this question, while others would disagree and say that â€Å"they caught a break†. Some people would say that a woman who has an abortion is immoral, while others would contend that it is her right to choose. These are just a few examples of how people’s opinions can differ on what it is right and wrong. Yet most people can agree that the behavior exhibited by characters in Dorothy Allison’s Bastard Out of Carolina, can at best be described as questionable. The character whose morals are obviously the most twisted, so much so that he comes across as malicious and evil, is Glen Waddell. He constantly lets his temper get the best of him, causing violent outbursts in the workplace that cost him numerous jobs. However, this is nothing compared to the mental and physical torment that he inflicts on Bone. He starts this method of abuse by sexually molesting Bone when she is nine years old in the parking lot of the hospital where her mother is giving birth (46-47). It then escalates into his constantly telling her that she is good for nothing and beating her for the most minor infractions (234). After years of this abuse the violence comes to its peak with a horrifying and brutal rape in which he tells Bone that he prayed for her to die and he would kill her if Anney did not come back to him (283). Anyone who can say that this is a man of sound mind should be locked in a cell along with him. Another character in the novel whose morals seem unintelligible is Bone’s mother Anney Boatwright. The ambiguity of her mora...

The Differences between First Degress Murder, Second Degree Murder, Research Proposal

The Differences between First Degress Murder, Second Degree Murder, Third Degree Murder, Voluntary Manslaughter, and Involuntary - Research Proposal Example This paper examines the differences between the aforementioned categories of murder and manslaughter in addition to justifiable homicide. In United States, different states have various definitions for murder and manslaughter crimes. First-degree murder is considered as unlawful killing of a person by another with malice and premeditation (Milgate 199). To convict an offender for this crime, the court of law must prove that the perpetrator had planned or contemplated about committing the crime, had evil intent and conducted the crime with severe malice (Milgate 204). Under Illinois law, a person is guilty of committing first-degree murder if in undertaking the action fulfils one or all of the three conditions. The first condition is the intention to kill, cause severe bodily harm, or be ware that the action has the potential of causing death to a person or a group of people (The Legal Defenders). The second condition is that the person undertaking the action is knowledgeable that the act causes death or has the capacity to cause grievous bodily injury to the targeted individual. Finally, the third condition under Illinois law when a person is culpable of first degree murder is when he or she commits or attempt to commit a violent crime besides the second degree murder(The Legal Defenders). Under the Illinois law, a person is culpable for second degree murder if the action fulfils the definitions of first degree murder accompanied by one or both of the following conditions. First, the accused person should be acting out of intense emotions that originate from being provoked by another person leading to accidental death of the aggressor (The Legal Defenders). The second condition that a person could be liable for committing second degree murder under the Illinois law is unjustifiable use of force under the guise of self-defense (The Legal Defenders). According to Ressler et al (203), a person is justified to use force on another where there is sufficient reason to believe that the conduct of aggressor is likely to cause grievous bodily damage to him or another person. In situation where there is no sufficient reason to prove the existence of a serious threat presented by the killed person, the person who killed can be held liable for second degree murder. In most situat ions, second degree murders arise from spontaneous actions such as fights. The legal penalty for the crime is less severe than first degree murder (David, et al 305).

Discuss.. The image of managers as rational and analytical planners, Essay

Discuss.. The image of managers as rational and analytical planners, decision makers and issuers of commands does not stand up - Essay Example They are the implementers of the operational strategies that have been set in the organization. The employees may be attached to the organization simply because they strive to earn a living out of it. The other members of the organizational community may be attached to the organization as their economic activity or as a source of some satisfaction. Besides, the nature of human being that deviates from the ideal situation does not allow them to operate collectively towards the achievement of common objective. There is a lot of diversity among the human resource. There is also need to plan the activities of an organization and make appropriate decisions at certain points in the organization. These require some kind of management, a way of passing information and coordinating the activities in the organization (Watson 2003, p4). The roles of the various employees need to be defined, there is need to supervise how the employees perform the tasks as a way of appraisal or dismissal, and th ere is a need to review the organizations objectives and evaluate the overall performance of the organization. There is a need to establish proper relation with the individuals that are outside the organization as well. ... The role of managers in an organization has received various scrutinies due to the ambiguity that exists in defining term itself. The operations in a given organization may not go on smoothly not because the top management consists of incompetent personnel but because the managers are not doing the right things. Watson (2001) thus describes management in three different aspects: management as a function, management as activities and management as a team of people (p.35). The kind of manager that Watson mentions includes both the middle manager and the senior manager. The roles of these managers are not specific and often change depending on the level of the hierarchy in which the manager falls. The different divisions that exist in given organization do not make it easy to tell the exact role of a manager. The managers themselves perceive the management role as that of leading a group of individuals or managing some kinds of property in an organization. It is thus difficult to identi fy a manager through the work that is performed. The roles also change with the changes that occur in the related sectors (Shelley, 2010, p.3). The way that the managers themselves view the management role has an influence on the overall performance of that manager (Stewart, 2002, p.39). The performance will also be affected by how other individuals perceive the role of the manager in the organization. The image that is mentioned here refers to the picture that is created in the minds of both the managers and the members of the community in an organization on the managerial roles. It refers to how the managers view their roles and how the employees and other stakeholders view the roles too. Some managers consider themselves as administrators and have very little to do with

Examining Strategies For Improving Medication Administration Nursing Essay

Examining Strategies For Improving Medication Administration Nursing Essay Providing care for the patient is the responsibility of nurses. Nurses are the one who are close with patients. They are responsible and accountable to make sure that the treatments and needs of patient are fulfilled. Medication administration is a part of the nurses responsibility in order to make sure clients get the correct medication as supposed. Medication administration error is a universal health care concern.Thus the strategy in improving medication administration system is important to enhance safety. The administration of medication by nurses is the final step in a process that involves multiple steps carried out by a number of health professionals (medical practitioners, pharmacists and registered nurses). The accuracy, efficiency and safety of administration of medications rest primarily with nurses. Medication administration is an activity that is prone to errors, in part because of the development of new medical devices and new drug products that available to fulfill the demand in health care setting. Thus to prevent medication administration error, six rights should be main concern for the nurses in giving medication. There are many type of medical error that leads to injury and may jeopardize patients safety. According to Hughes and Ortiz (2005) the most common type of medical error that happen universally is medication error. Senior citizens are at the highest risk of being affected by this type of errors, since they are the largest consumers of medication (New Tech Media, 2006). However, this is especially true in regards to medication errors. A proper understanding of the contributing factors that increase medication errors is the first step toward preventing them. There are many factors, such as training deficiencies, undue time pressure, and nursing shortages that may have contribute to medication errors. The amount of nursing education and the years of nursing experience are two factors that may have relationship to medication errors. Due to the fact that nursing staff is a large cost to hospitals, these organizations are constantly trying to manage expenses. This is supported by Yang (2003 ) who states nursing professionals typically represent the largest employee group in hospitals, and have become a primary target for redesign measures. Consequently, medication errors are costly and seem to be proportional to the staffing of nurses. Since nurses make up such a large portion of the staff population, it is important to understand the incidents that influence behind these medication errors. These issues of medication errors were present even at the time when Benjamin Franklin founded Americas first hospital and he stated that patients ultimately suffer and die without good nursing care (Clarke, 2003). 1.2 PROBLEM STATEMENT Health care professionals work is hectic and stressful. All the heavy workload had causes the nurses to pay much less attention in giving proper medication administration to patients.I discovered during my clinical posting that sometimes the nurses tend to take for granted so as whether the patient did consume the medications given or not after leaving the medication on the patients bedside . Occasionally proper procedure was not followed by nurses for medication administration. It happens when the nurses just copy down the name of patient in a piece of paper during pass over the report , without rechecking in the patients medication administration record. This unintentional act sometimes will lead to medication administration error when bed of the patient is exchange with another patient or the patient has been transferred to the other ward or may be discharged from the hospital . There is also happen an error due to some of the nurses borrowing medication from another patients cart and administering an unlabelled medication or syringe. This improper practice will harm the patients and can cause medication administration errors. On the other cases, the nurses do not follow the correct time for medication administration. For instance, they just merely combine the medication that should be given at 4p.m with 6p.m. In that case, the effectiveness and toxicity of medication can be query. Thus, medication error can be some way again linked to an inconsistency applying the six rights of medication administration. Definition of terms Nurses A person educated and trained to care for the sick or disabled; One that serves as a nurturing or fostering influence or means (C.L.R James,2009 ) Working experience Work experience is the linking of a period of activity in a work setting (whether paid or voluntary) to the programme of study, irrespective of whether the work experience is an integral part of the programme of study(Harveyet al,2002) Incident Any other incident in which researcher is unsure about exposure potential. 1.3 SIGNIFICANCE OF THE STUDY Medication administration is a crucial part in nursing . Having a study concerning the incident of contributing factors that lead to medication error is important as this study creates awareness about the medication error and it consequences will affect patients safety. Such prevention methods could be taken to reduce the cases of medication error in hospital setting. Through this study, the management team of the hospital may take a serious action to solve the problem arised. Besides that, the nurses may realize the significance of medication administration process to overcome the factors that contribute to medication administration error. Furthermore, nurses need to perform their duty in ethical manner and obey the correct standard procedures as guided by the ministry of health. The function beyond the limit of nursing practice acts or ones ability is to endanger clients life will put the nurses open to malpractice suits such medication administration error. Therefore, it is crucial part for nurses to always be aware of entire the medication administration process in order to maintain the safety of the patient. 1.4 RESEARCH OBJECTIVE 1.4.1 General Objective The general objective for this study is to provide reasons about incidence of factors that contribute to medication error among the nurses. This study also helps to determine the barrier towards medication error which can used as guidelines for the nurses to be more caution on certain situation during administering medication in the hope of facilitating improvements to medication administration processes. 1.4.2 Specific Objective The specific objectives of conducting this research are: 1) To identify the most factors which contribute to medication error 2) To indicate the relationship between working experience with all the contributing factors which potentially lead to medication error 1.5 RESEARCH QUESTIONS What are the commonest factors that contributed to medication error perceived by nurses? Is there any relationship between working experience with all the contributing factors which potentially lead to medication error? 1.6 ADVANTAGES OF RESEARCH 1. This study able to provide reasons about factors that contribute to medication error among the nurses. 2. This study helps to determine the barrier towards medication error which can used as guidelines for the nurses to be more caution on certain situation during serving medication LITERATURE REVIEW Introduction Nurses are the group of health care providers who are closest to the patients. They have a major responsibility in administration of medication for patients, particularly in the wards. The issue of medication administration error (MAE) within the acute-care setting has long been the focus of research. Since nurses are intimately involved in the delivery of medications and the final person who occupy the link on medication administration, thus they are accountable for the responsibilities in medication error. It is important for nurses to understand the factors that contributed to medication administration errors in view of the fact that the burden of reporting medication error falls heavily on nurses. Prevalence of medication error Medical errors harm an estimated 1.5 million people and kill several thousand each year in the United States of America (Joint Comission International ,2007).In Malaysia the Malaysian government does emphasize on the medication safety whereby the government encourages researchers to conduct research on medication safety (Institute for Health Systems Research ,2008). In view of the fact that the prevalance of medication administration error is increasing globally, the serious action should be taken to minize it from occur. Medication The oxford Concise Medical Dictionary stated that, medication is a substance that is administered by mouth, applied to the body, or introduced into the body for the purpose of treatment (p.417). Medication Administration In administration of medication, the nurses must follow several principles that have been set up to prevent medication administration error. While administering medication, the nurses should implement the Six Rights to make sure the effectiveness of the drug effects and gain improvement in treating the disease. The six rights are involved before, during and after giving the medication. According to Bennet (2008), the six rights of medication administration includes the following; right medication, right dose, right client, right route, right time and right documentation. It is a must for the nurses to follow the standard protocol outlined for the implementation of medication administration. Medication administration error An article from joint comission international (2007) stated that errors are common as medications are procured, prescribed, dispensed, administered, and monitored but, they occur most frequently during the prescribing and administering actions. Since, the parts of administering process are bound to nurses job, so that they are responsible for their action and conduct. Mayo et al (2004) found that some medication errors are not reported because nurses are afraid of the reaction they will receive from the Nurse Manager. Hence, the real incident of medication error that occurred cannot be measurable since the nurses do not take responsibility to report the incident. Medication usage is a multidisciplinary process, which begins with the doctors prescription, is followed by the review and provision of medications by a pharmacist, and ends with the preparation and administration of the medication to the patient by a nurse. Inadvertent errors or accidents are encountered if there is a break down at any stage in this process, which leads to overwhelming consequences for the patient and for the career of the healthcare professional (Gladstone 1995). The impact of medication errors can be devastating to the confidence and self-esteem of the healthcare professional. Consequently, healthcare professionals are unwilling and indisposed to report any medication error unless there is an obvious harm to the patient. Factors that contribute to medication error Nurses need to prioritize significant responsibilities for safe patient care. In this hectic and stressful environment, serious medication errors are appearing significantly as a basis for successful malpractice cases against nurses (Lilley et. al, 2005). Proper medication process and system analysis approach are the essential link in the prevention of medication errors from occurring in health care setting. Asim and Nagy ( 2007) in their study showed that there were statistically significant differences in responses across the participants years of experience and the current clinical working area about the medication error to occurred. Research done by Fu et al.(2007) showed that medical wards and intensive critical units are the commonest areas for medication error. Knowledge and practice Henry (2005) revealed that, most of the types of medication administration errors occurring are due to omission of dose, wrong doses. The other study done by Fu et al. (2007) showed the wrong dose is at the highest to occur. Undeniable to say that, most of the errors can occur when the nursing duty during medication administration is not taken seriously. In addition, medication error can occur due to nurse attitude who do not check whether the right patient received the right medication. Medication administration error can occur when the nurse failed to check the patients arm band with the patients medication administration record or calling the patient by name to make sure the right patient receiving the medication. According to (Nancy et.al 2003 ; Ulanimo et al, 2007) through their observations that had been done, they found that nurses were failing to compare the patients wristband with the medication administration record before giving the medication to the respected patient. Whats more, spelling errors and the similarities amongst the appearance different medication can cause confusing to the nurses. Unfamiliarity with drug medication such as new drug name with similar drug packing can cause medication administration error Fu et al (2007). The potential for medication errors will increase and leads to injury to the patient. Cases reported by FDA-Food and drug administration (2008); medication errors associated with Flomax and Volmax, Zantac and Zyrtec caused patient to suffer. For that reasons, unfamiliarity with the medication can cause the medication error to occur. Besides drug administration, there are other factors that lead to medication errors taking place such as interruptions while administering the medication. In the research done by Pape et al.( 2005) ,it mentioned that conversations with other staff members and visitors or multi-tasking that occurs during medication preparation and administration can result in errors. Thus, the normal procedures for checking the six rights are easily neglected. So that, reducing unnecessary conversation and other distractions is an important aspect in administering medication safely to patients. Personal issues Abandon the six essential rights of administering the medication, are latent conditions evidenced to be a part of factors that contribute to medication error. Personal factors mentioned in connection with prescribing errors included physical and mental well being, skills, and knowledge. However, there are few associated factors that contributed to medication error to happen among nurses. The factors are time pressures, fatigue or exhaustion a part of nurses (Mayo et al; Ulanimo et al, 2007). Study by Nick Barber et al (2002), 18 interviewees reported that they had felt tired, hungry, or unwell, and that these factors might have contributed to the error. A considerable percentage of reported that they omitted to give medication or gave at the wrong time, and also indicated that other nurses gave incorrect medication or incorrectly administered treatments; practice issues which were related to the nursing shortage and causing moral distress (Marj.T Mrayyam,2011). Healy and McKay (2000) also found workload to be most significantly correlated with mood disturbance. However, Payne (2001) did not find a significant relationship between workload and burnout, although levels of burnout in her study were lower than in related studies. The reasons for this variation are unclear, but seem likely to include differences of stress hardiness (Simoni Paterson 1997), of coping mechanisms (Payne 2001), of age and experience (McNeese-Smith 2000) or of the level of social support in the workplace (Ceslowitz 1989, Morano 1993, Healy McKay 2000). Hospital setting and workload The terms hectic, hassly, and busier than average were used to describe workload. Sometimes, workloads made nurses change their usual practice to try and save time From the study, it was shown that, it is not only the practice itself that contribute to medication administration error but other external factors can also contributed to medication errors such understaffing, inexperience nurses, design deficiencies, and inadequate equipment while administering the medication( Carlton Bleggen, 2006). Nurses and workload is one of the major factors that should be considered .Most of the hospitals are lacking of nurses and this small issues will lead to big impact of nurses practice. Stordeur et al. (2001) attempted to rank stressors in order of severity of impact, the main ones being ranked as: à ¢Ã¢â€š ¬Ã‚ ¢ High workload, à ¢Ã¢â€š ¬Ã‚ ¢ Conflict with other nurses/physicians, à ¢Ã¢â€š ¬Ã‚ ¢ experiencing a lack of clarity about tasks/goals, à ¢Ã¢â€š ¬Ã‚ ¢ a head nurse who closely monitors the performance of staff in order to detect mistakes and to take corrective action. Lack of staff Staffing issues were also mentioned and included inadequate staffing, the effects of new or locum staff, and attending to another doctors patient. Providing cover for absent colleagues not only increased workload but also meant that care was being given for patients the doctor did not know. Several doctors drew the distinction between those patients whom they had admitted and knew throughout their stay, and those whom they had to take over for only part of their treatment. The most commonly used unit-level workload measure is the nurse-patient ratio( Pronovost PJ et al (2000). The nurse-patient ratio can be used to compare units and their patient outcomes in relation to nursing staffing. Previous research provides strong evidence that high nursing workloads at the unit level have a negative impact on patient outcomes (Olson V et al, 2004). Hospital nurse staffing is a matter of major concern because of the effects it can have on patient safety and quality of care. Nursing-sensitive outcomes are one indicator of quality of care and may be defined as variable patient or family caregiver state, condition, or perception responsive to nursing intervention (Needleman et al, 2003) Briefly, medication administration error should be avoided because direct results of the error can cause harm to the patient as well as increased health care costs. Moreover, indirect results include harm to nurses in terms of professional and personal status, confidence, and practice. Thus, to maintain the professionalism in delivering of care to the patient, medication administration process should take seriously among the nurses. In a 1999 study conducted by the Institute of Medicine, entitled To Err Is Human: Building a Safer Health System, It is estimated that medication errors cause over 7,000 deaths annually. This chapter will explain on the research methodology of the study consist of research design, population, sample, setting and data-collection instrument. 2.1 Research design Research design is an overall plan for conducting study on order to answer the research questions (Polit et al; 2001: 67). The research designs signify the steps which will be used in conducting the research. According to Burns and Grove (2001:223) , research design is a guideline for the research process in order to achieve the intended result which will be the reflection of reality. Polit (1999:155) state that the research design will includes the most important decisions in research methodology that researcher makes in conducting the study. This study used cross-sectional; quantitative non-experimental correlation study using assisted-administered questionnaire to reveal the question incident of contributing factors that lead to medication error. 2.2 Population and sampling Population is an entire group of people that is interested to the researcher as define by Brink (1996:132-133).Burns and Grove (2001:366,810) define population as the whole set of individuals who meet the sampling criteria. A sample taken from population and it will include in the study which representing research population, if random sampling procedures has been adhere to. Random sampling would give every individual in the whole population the same and unbiased chance of participating in the study. Simple random sampling will be used in this study. The respondents are consisting of Registered Nurses in Hospital Tengku Ampuan Rahimah, Klang (HTAR) .The sample will be taken randomly from several discipline in HTAR. In order to get significant result, a sample size calculation formula has been used to determine the size of the sample for this study. Inclusion criteria for respondents are: Registered Nurse with Malaysia Nursing Board Understand Malay and English language and generally healthy. Have working experience at least 1 year. The participants are involves in direct patient care. Have an experience in administering the medication Exclusion criteria area: Unregistered nurses with Malaysia Nursing Board Have working experience less than 1 year Do not have an experience in administering medication 2.3 Research setting The study setting will be conducted in HTAR. The unit chosen is medical ward, surgical ward, Intensive Care Unit, Obstetrics and gynecology ward, Pediatrics ward, Emergency Department and orthopedic ward. HTAR is chosen because affordable cost and time constrain for me. 2.4 Study period Data collection February to April 2011 Data Processing/ analysing and writing up April to May 2011 Grantt Chart (refer to appendix ) First phase Screening for initial data from hospital record (secondary Data) in Hospital Tengku Ampuan Rahimah Identify the discipline units to be study Second phase Pilot study done to confirm feasibility of the study Collection and analyzed the questionnaire Third phase Obtain consent from subject The data are collected by using questionnaire in order to obtain the information regarding the study Fourth phase Analyze the data collection and writing up 2.5 Data collection Dempsey and Dempsey (2000:195) define questionnaires is a paper and pencil data collection instrument filled in by the respondents for the purpose of the research study. Characteristics of questionnaires had been listed out by Gillham (2000: 5-8) as below: A questionnaire is less expensive than interview. A lot of sample can be taken within short period of time. Questionnaires can reduce cost of using telephone and travels thus it is also feasible to be used by researchers who have full time jobs. Questionnaires are an easy way to get more information within a limited period of time. Respondents able to complete the questionnaires at their own time without pressure. Anonymity can be guaranteed. Reassuring the respondents that no one will know any feedback from them. This aspect was deemed to be very important in this study as the respondents could be reassured that they could state their honest opinions about factors might contribute to medication error without fear that employer would take action to them if their knowledge level is low. The research contents will display out numbers, facts and figures .No names should be mentioned not even the researcher nor did the supervisor know who provided which answers for specific questions. No different questionnaires are distributed; all questionnaires are standardized to limit the bias. 2.5.1 Development of questionnaires The development of questionnaires was based on the literature review (Chapter 2) and other research instrument used in similar studies. The questionnaire is compiled and discussed by researcher and supervisor. Changes suggested were implemented. Most of the changing pertaining to rephrasing specific items so that each items had only issues to address rather than multiple issues. There is part of questionnaires that had been corrected and combined from previous study to ensure the objective of study answer. 2.5.2 Pilot Study Pilot study was done to determine feasibility of the instrument .This shows a trial administration of newly developed questionnaires in order to identify the potential -problem encountered by participant. Brink and Wood (1998:259; 373) explained that pre-testing enabled the researcher to interact with the participant similar but they were exclude from the real respondents participating in actual study. These ensure the researcher to predict what would happen to the main study regards to participation. Pilot study was conducted with five staff nurses with year of experience more than 1 at the same hospital but different target unit which they will not selected to participate in the actual study. No apparent problems were encountered during the completion of the questionnaires. 2.5.3 Structure of the questionnaires The questionnaire is conducted in Malay/English language and is assisted-administered questionnaire. The questionnaires will be distributed to the nurses in the unit by the researcher. The researcher needs to explain about the objectives, target population and significance of the study. Some of the respondents will answer the questions by themselves and some of them need assistance while answering the questionnaires. The data obtained will be statistically analyzed using SPSS software. An effective strategy for nurses will be formulated based on the findings. The questionnaire is distributed to the whole chosen unit consist of 30 registered nurses in HTAR. The questions based on a structured questionnaire that composed of three parts.(refer to the appendix) Part 1 that consists of demographic data : year of working experience Part 2 Question consists of six incident of contributing factors which potentially lead to medication error. Factor 1: This section using closed -ended question (dichotomous question) directed towards the knowledge regarding the process for medication administration. This questionnaire edited from study that had done by Raja Lexshimi R.G et al (2009). Factor 2-6: This section is questions regarding factors contribution to medication error edited from the result of study done by Fu et. al (2007) which categorized into five categories which using Likert scale. The respondents are asked to indicate how much the declarative statements given from each category will influence to contribute to medication error. Personal neglect Heavy workload Unfamiliarity with medication New staff Complicated order 2.6 Data Analysis To identify the level of knowledge among nurses towards serving medication .It is also to identify the most incident of contributing factors which lead to medication error. A significant value of 0.05 was used to test for significance for all statistical tests. The chi square analysis was performed to determine the association between incident of contributing factors and the years of experience. The data collected will be analyzed using Statistical Package for Social Science (SPSS) version 18. 0. 2.7 Research Variable Dependent Variable In this study, the dependent variable is years of experience Independent Variable In this study, the independent variables are the 6 incident of contributing factors ; Knowledge, Personal Neglect, Heavy Workload, Unfamiliar Medication, Newly staff and Complicated order. 2.8 Validity and Variable According to Polit and Hungler (1999:418), validity is the degree to which an instrument measures what it is designed to measure. The content of the questionnaire is adapted from the previous survey and study that had been done. Moreover the questionnaire used will be reviewed by a philosophy doctors (PhD). 2.9 Ethical consideration Permission from HTAR will be obtained from hospital authority to conduct this research. Each participants who involve in this study will be given inform consent. Furthermore, before distributing the questionnaire, each participant will be explained about the purpose of the study and consent form was given to the participants. They are free to agree or decline their participation in the study at any time. All information obtained from the participants will be kept confidential. The participants took 15 to 30 minutes to answer the questionnaire and the researcher collected it back after finished answering. Polit and Hungler (1999: 131-134) revealed that researcher therefore need to exercise care that the rights of individuals and institution are safeguarded. Administer medication is an everyday activity in nursing practice and nurses should have enough knowledge in order to perform this important job. The finding of these study shows that nurses knowledge in serving medication is sufficient. Most of the f=29 (96.7%) registered nurses able to answer the questionnaire correctly automatically make knowledge as low incident that will contribute to medication error. Reflected from the result, King (2004) and Coombs et al have similar result which reported the same. Nurses have the knowledge but the knowledge is limited especially on drugs administration. 43.3% did not know the frequent recommended site for heparin injections is at the abdomen (Caffrey, 2003).Nurses should improved their knowledge and highlight on different route of administer medication. Gerry Helen (2003) reported that time-span of experience and level of professional education was linked with level of knowledge in the administration of medications. Having extra educational qualifications among nurses were found to have contributed to a improved knowledge of medications. However in this study, 26.7% nurses practice wrongly which they did not check the patients ID band prior administering medication. It is also surprise 23.3% nurses violate the practice by administering medication prepared by other nurses. Benners and others (2002) agree source of errors include delivering too much medication, missed doses; wrong route; and wrong medication deliver due to misidentification of client. Mattan (1998) revealed that administering medicine effectively was a aspect of practice but it lacked quality, which is due to poor knowledge in pharmacology and practice. Manias et al. (2004) indicated that nurses infatuated the necessary knowledge and skills in medication administration such as monitoring effects of medication, assessing and evaluating patients condition prior to medication administration. In many cases drug errors arise as a result of nurses failure to follow policy (Keill and Johnson, 1993). 2) Personal Neglect From the data analyse, 18 (60%) nurses show personal neglect is in the low incident contribute to medication error. Nevertheless 4(13.3%) nurses indicate in the middle of administering drug, there was interruptions by others. A new study shows that interrupting nurses while theyre nursing to patients medication needs increases the likelihood of error. As the number of distractions increases, so do the number of errors and the risk to patient safety.    According to the study reported in the April 26, 2010 issues of the  Archives of Internal Medicine, four interruptions in the route of a single drug administration doubled the likelihood that the patient would experience a major mishap. 26.7% nurses indicate that personal neglect as a medium indicator of medication error. 3)