Organizational Systems and Quality Leadership - WGU RTT1 Task 2 (FMEA-Focused)

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Introduction
In this post, I will discuss in detail how to get over to the part involving FMEA in RTT1 Task 2. The task, overall, is quite complex, but this FMEA part, and what follows it, is far more challenging. Personally, I have had to write more revisions for this part alone than any other paper for WGU.

Given that not much help is available online (my personal experience), and your mentor will share with you the FMEA application material that does not focus on nursing, it can be really frustrating (I know!); hence, I am trying to make your life easier and hope that you will save countless hours of your precious time by going through my post.

FMEA (Failure Modes and Effects Analysis) is a useful tool, and WGU urges that its students know how to apply it to their workplace, and, trust me, they are not fooling us here. It really is useful.

Root Cause Analysis
The task starts with (A) the Root Cause Analysis (RCA) that focuses on understanding the basic causes of Mr. B's sad demise: Lack of staff, crowded ER, lack of coordination, and monitoring plus more doses than needed.

Improvement Plan
In the next section, Improvement Plan (B), you have to discuss an improvement plan (employing tools such as PDSA, checklists, audits, feedback, etc.) that will ensure such sentinel events as those with Mr. B won't repeat. So, you would say that flex staff will be added, coordination will be improved, etc.

Change Theory
Ahead is the section that asks you to discuss in detail the role of a Change Theory (B1) in your plan. This part is to show the grader that you know how to theorize change in your organization and situate your Improvement plan - as proposed above (B). Quite a few change theories are available, and you can use just one theory here.

FMEA
And, NOW, the FMEA section (C). First things first. The FMEA tool is very complex and is used by major organizations. For you, as the instructions clearly lay, the task is to apply it to just one process addressing each step. This is the key.

It is connected to all the sections that precede, i.e. your RCA and the Improvement Plan.

So, let's say that we have devised an improvement plan that (with other areas as highlighted above) focuses on patients like Mr. B. Probably, we are convinced that Mr. B (and similar patients) have an ASA Score III or higher. There are quite a few issues that caused his unwanted demise, but it was the sedation policy that can be our focus here: Remember just on process.

To cut short, FMEA helps us to identify risks and manage any failures before they can occur. So now, we want to apply FMEA here so that things won't get again to the same point as they did for Mr. B. In other words, we want to make sure our new ASA-related sedation policy won't fail and our patients will be treated well. As we noted above, there are quite a few other things than just the sedation administration. It involves addition of the flex staff, training of all the staff (RN, flex, physician, and the anesthesiologist), and coordination among them in such a way that a patient with ASA III or greater is administered the dosage within the limit of safety.

EDIT: Syllabus REVISION hath arriveth!!! There are now more than 1 versions of this paper as per the profile of  a student. Remember, WGU's syllabus is proprietary?

So, in another version, that you might have, there are no Pre-steps and Three-Steps (by the way it's way too confusing, isn't it?). Instead. all of these steps are combined as Necessary steps for FMEA that you are required to take. BUT...these are the same as given below. Just combine them and number them from 1 to 6/7. 

Pre-steps 
This section might sound quite complicated to you, but it is NOT. We just need to apply our common sense here. For instance, we're saying that a patient with ASA score III or greater would be handled under this plan. We have already highlighted many changes from staff, training, to coordination.

So, simply put, the pre-steps are to focus on the mechanism of FMEA before it is employed. It is like preparing your horses before the actual journey.

Thus, in your pre-steps, highlight the addition of the flex staff so that such a patient is not left unattended. Training of all the staff would alert them all for such a patient. Next, let's introduce a checklist here. This checklist, noting the ASA score, will be filled, signed, and pooled together by all the relevant staff: the RN (or flex), the physician, and the anesthesiologist: The Multidisciplinary Team. Unless signed by all of these stakeholders, NO further treatment can be offered to such a patient, etc.

In addition, let's also introduce here the Risk Priority Number scale to assign numeric value to the likelihood of occurrence or frequency, detection, and the severity or seriousness pointers. The RPN is to be discussed in the Three-Steps section below; here we're just introducing it, so say that, the MD team would be trained to use RPN beforehand.

Hence, the summary of our pre-steps can read: Patients with ASA score III or higher are monitored with great care; all the staff collaborates closely to treat the patient, and the conscious sedation policy (including any other treatment) is administered with strict monitoring involving the use of a checklist when the team is trained for using this tool. A decision is made collaboratively only.

Three Steps
Here the application of RPN is discussed in detail. First discuss the tool in some detail (using credible references). Next, we would say that because a patient like Mr. B has ASA score III or greater, the score would be much higher for severity (or seriousness), moderately high for frequency (it's relative here - it depends on the age group a town has; however, for the town like we have in the scenario, we can go for moderate score for frequency), much lowly scored for detection because we've already experienced a case that resulted in Mr. B's sad demise.

Hence, the pooled ratings would certainly alert the MD team to be extra cautious, etc., etc.

You do NOT want to forget that this entire process of applying FMEA would be cyclic and will be improved by time. You can say that a flowchart will be introduced to improve our FMEA process, etc. We need more detail here than I have written - or you're going to disappoint the WGU guys grading your paper! :-D

The sad news is, we're NOT done here :-(. The complication continues as WGU wants to make sure you understand how you can test the plan in an actual intervention!

EDIT: Whereas in this version you need to focus on just ONE process, in another version, that you might be receiving, you have list 4 such processes in the FMEA table. Be mindful of that. However, it's easy. Pick any four: (1) Staff training, (2) Staff's concept development, (3) building a team for random assessment, (4) Collaboration...., etc.

This brings us to C4. Interventions.

Here discussing a tool like PDSA (Plan, Do, Study, and Act) is mandatory, or the WGU guys will be very upset with you!

First, you are to state a plan question: How can a patient with ASA score III or greater can be treated carefully with our new conscious sedation policy?

Now The Plan: The checklist will be our major source for data to find out if our plan is working. It is because we've planned that no treatment is possible UNLESS the checklist has signed feedback/remarks by at least the RN/Flex staff, the physician, and the anesthesiologist. Thus, our plan is to use this data to test the vigor of our Improvement Plan.

DO: We can't just start testing this plan to all the patients meeting this criterion (ASA). So, here we will say that we will handpick just ONE patient first and carry out this intervention i.e., see how our checklist is working for him/her.

Study: As our intervention is put to reality check, we will see how it is going: Whether we are improving or not, etc. Here, we need all other data as well: pre-admission record and history, ongoing treatment and handling, and the success of the intervention. Do you see that every bit of our plan is coming along so very clear and is laid down step-by-step? This is what those guys at WGU want to see (my experience).

The Act prompt can highlight that we will ensure further improvement is made to any weaknesses in the plan found through our PDSA, for example, we might consider introducing a smartphone application for the checklist, etc.

For D. Key Role of Nurses, you can write a detailed portion highlighting the immense importance attached to this role in health care not just in US but all over the world.

GOOD NEWS! We're done.

I hope with this carefully crafted post, I have helped you save some of your precious time. Happy Nursing!

Last, if you like the tutorial/walk-through, do not forget to drop a line or so. Should you need any further assistance, I would be happy to response.

Email me at: meokhan2/at/gmail/dot/com

Freelance Academic Writer or a Company?

If you're looking for hiring a freelance writer to handle your writing project, you should make sure that the writer you're dealing with is legitimate, reliable, honest, and qualified.

These four attributes are a MUST for any business transaction whether with individuals or with companies.

However, when it comes to freelance writing, things can turn both highly beneficial or badly disappointing because of its inherent strengths and downsides in today's digital world.

The most basic question is how to find a freelance writer in the first place? There are quite a few virtual marketplaces (agencies) like oDesk, Elance, GetAFreelancer, GetACoder, and writing companies where you can work with individual writers.

I cannot name any academic writing companies here because I do not want to sound connected to any of the companies. Secondly, online scam companies are growing in number as much as freelance writers; thus, I better not mention any.

Before we can move any further, I should ask you a primary question: Why on earth hire a freelance writer?

The answer is quite straightforward. Freelance writers have their own strengths that are not present with a big company.

Some of the strengths are:

• Personal contact, communication, and collaboration between you and the writer.
• Smaller projects for quicker turnaround time.
• You don't need a business strategy to outsource your work.
• Good for limited budget projects.
• Timely response

Though agencies and big companies may be well-known in their market niche, it is not difficult to understand that their writers also work as freelance writers.

Outsourcing your work to a company or agency keeps you from directly contacting to their writers because of such obvious reasons as concealing the commission earnings. This puts you at a distance from your writer and all you do is wait for a response from them. Company-mediated communication (mostly via the email) is full of semantic noise, barriers, and flaws.

Sometimes, this results in acute frustration for both the writer and you.

When you outsource your work to a freelance writer, you have every liberty to communicate with them: Email, Skype, phone, or any other means - you name it.

Almost ALL the companies, agencies, and related entities over the Internet require that you pay the complete project price upfront. Though you pay them in one-go, they do not and cannot guarantee to deliver most satisfactory work. In such a case you end up asking a writer (in case of a legit company) for multiple revisions!

Most of my clients hire me for these reasons.

If you google for companies and writers, you'll find countless results that lead to in the middle of nowhere. However, there still are place over the net that can help you find legitimate freelance writers who are also qualified (obviously many other people working in the same field.

• Once you shortlist a few writers (remember to do a prior research beforehand), ask each of them to provide you with an outline and or synopsis of your work.
• Follow the same precautionary steps I mentioned in my previous post.
• Soon will the things start making sense to you about who is the one you'd like to outsource your project to.
• Always follow an installment plan for paying the writer only after you receive the installments of your work.
• Always run similarity-index check on the pieces you receive.
• Pay only through a reliable and secure means.
• Be quick to ask for any revision, adjustments, or corrections on the pieces of your work.

With these steps, I am very hopeful that you'll get your work done satisfactorily without being scammed and frustrated.

Good luck!

Essay Writing Scam - the Do's and Don't's (Internet Companies)

This post covers the present-day scam trends in the essay writing industry. It also offers a few effective steps to avoid scam in the first place to save you money, time, and stress.

The most common form of scam has already been discussed in the previous post. This is a continuation of the same.

Here, I will cover the companies. In the next post, I will talk about freelance writers.

Today, as more and more people have access to the internet and communication technologies, business becomes riskier even though there are certain filters applied both at the physical and virtual level of all the transactions taking place over the WWW.

One reason for this growing fluidity  and porousness is the lack of global jurisdiction.

Therefore, today, it is more a matter of individual scrutiny and personal safety measures that one can take to avoid any possibility of being scammed. Within essay writing industry, there are certain Do's and Don't's that can safe you from a lot of unwanted stress.


DO's in the essay writing industry

1- Always do your research before hiring a writer or a company.

2- Google the name or brand by adding 'scam' to the term or name.

3- Always check the credibility of the website that returns results of some company you're looking for. Do not just think upfront that some company is a scam only because it has an unhappy customer. You need to dig deeper.

4- Do a WHOis record check to find out the registrant's address, age of the domain, and hosting server. It will give you a good idea of the company's physical presence. It will also help you verify facts presented on their website.

For instance, you can cross-check their claims (if any) with their domain age: We've been in business since 1999 versus Domain registration data 2008!

5- Try to read carefully the webcopy on the company's website. Does it really look professional? What about the overall look of the webpage?

6- If you're satisfied with these initial research, ALWAYS directly talk to the support via phone. Use a public phone if you don't want to leave your personal number with them. Talk to them, find out if they really sound LIKE a company.

Doing the DON'T's in the essay writing industry

1- If you're doing business with a company for the first time, NEVER reveal your institutional, personal, and other information that may be sensitive. Yes, playing safe is ALWAYS important in life especially over the internet. Personally identifiable information and its security are now becoming global phenomena.

2- Do NOT order a BIG paper, project, or task on the first go. Always start with a smaller paper. This will give you a better idea about the overall business model of that company.

If they are a scam company, their first product will show poor quality in terms of writing, research, formatting, citation style, and so on. Who knows, you may end up receiving a completely plagiarized paper altogether.

However, a legitimate company will provide a product par excellence.

3- DO NOT hesitate to ask the support of the company to keep you in contact with your writer. Knowing your writer PERSONALLY is always good for effective communication and better results.

4- Do NOT hesitate to ask for revisions or any other adjustments that you may find necessary to be done. Remember, you're evaluating the company on the way of becoming their loyal client.

ALWAYS keep in mind that all that glitters is not gold.

If you carry out these steps, I am sure you'll soon understand the differences between a reliable and scam essay writing companies.

Should you need any further assistance, please do not hesitate  to reach me. I would be happy to respond to your queries.

Happy writing!

The MOST Common Scam in the Essay Writing Industry

My years-long experience in the essay writing industry, my communication with a diverse range of people within the same industry, and my personal interaction with global clients and writers have all contributed to my understanding of the MOST common types of scam that affect both students and writers on a regular basis.

I must say that a majority of these scam incidents involve MONEY on the forefront of every transaction. Most often students are ripped off their hard-earned money by freelance writers and online essay writing companies.

A student googles or bings for online essay writing help. S/he comes across quite a few online resources and companies that guarantee a premium writing product for a reasonable price. The student places an order mainly for two reasons:

(1) They can pay via PayPal (assuming their funds would be secure in case of any disputes);
(2) The website design, contact details, and other relevant information make them believe they're the best option.

Now, let's demystify the PayPal-Secure-Payment myth.

PayPal DOES NOT guarantee, cover, or stand by you if you purchase a DIGITAL PRODUCT such as an e-book, music, template, and (in our case) academic essay! Wooh! User Agreement, and PayPal Community are quite useful resources on these matters. Have a look. The PayPal User Agreement explicitly states (clause 11.10) that, "Intangible items, licenses for digital content, and services" are NOT "eligible for PayPal seller protection".

Thus, today, virtual essay writing companies are swarming the WWW with an incessant speed because they have a countless number of potential clients - new students every semester looking for help!

What really happens is that a student places an order with an online writing company and receives either a plagiarized essay or something that is hardly to be regarded some standard writing - making it almost impossible for the student to acquire moderate grades!

The student, enraged and frustrated, contacts PayPal to initiate a chargeback only to learn that it is not possible. Read here about how to make relatively secure payments online.

Second, it is very likely that the company starts threatening the client to leak out their personal and institutional information to their school if they do not stop spreading word over the internet!

The bottom line - the student ends up feeling more frustrated and furious over all the happened to him or her. However, the learning has come for a much higher price: time, money, and most of all the educational career being jeopardized.

Most of these companies know their art of scamming their customers. They use fancy language and multimedia, attractive webpage design, and libelous claims like:

- They've been in business since 1998;
- All of their writers are PhDs;
- They guarantee highest possible grades for their writing products, and so on.

Although I am from Pakistan, I am NOT misrepresenting ANYTHING about me, my background, my language proficiency, etc.

Since it is my top priority to be honest in my business, I think the reader can tell whether I mean it or not.

I am sure this post has demystified the  notion of ONLINE PREMIUM help. Kindly, do look around before blindfoldedly believing in the claims made on a website.

I would be honored if I could be of any assistance to you. Do leave me a message.

SNEAKY REDIRECTS/CLOAKING, THIN Content and MY WEB PRESENCE

Google defines sneaky redirects or cloaking as, "Site appears to be cloaking (displaying different content to human users than is shown to search engines) or redirecting users to a different page than Google saw". Learn more about it here.

Similarly, THIN content is also a libelous cyber activity. It is defined as, "automatically-generated content or copied content". Cookie cutting is one of the many techniques used for this strategy as well.

Under these two libelous strategies, some cunning webmasters are able to redirect search queries (intended for another but similar content/information) to their webpage.

For instance, people who search for my name in Google, are redirected to a NUMBER OF different websites, discussion forums, (including the ones I regularly visit and the ones I don't even know). This is one bad move since people think that I am affiliated to these custom essay companies and work for them. I must say that when I learn people have placed their academic writing orders with those companies I regard that acute credulousness.

This is because a general user who uses the internet for serious business, and not just for trolling, must be aware of common search strategies that include how to locate the information one is looking for and not to get redirected to some other source.

Recently, quite a few people have reported to me that they were looking for me on such-and-such website because they "found" me there. 

I would most humbly bring out to my reader that I am NOT a BIG company nor am I associated with ANY custom essay companies either in Pakistan or anywhere else.

I am just a writer who does have links with other writers that help me produce high-quality 'designer' content for my clients. Yes, delivering 'designer' custom academic writing is my strength and my niche.

Hence, it would be convenient for the reader to learn that they should avoid being redirected to any other source of information that misrepresents my name and shows (through cloaking and thin content) that I am somehow associated with them.

As I have established my own blog now (this blog), and my website, www.meokhan@meokhan.com, along with my Google+ presence, I am sure you will not find it hard to reach me to verify facts.

Please feel free to reach me for an inquiry for your academic writing or place an order with me. I would be honored to serve you (only if I am sure I can justify with your order).

MeoKhan

MeoKhan Writer - About me

This is MeoKhan, academic essay writer.

The purpose of establishing this blog is quite straightforward.

These days, I receive quite a few inquires from my clients asking me a number of things that simply tell me that other 'scam' writers are using my name to contact people from different forums where I am a member.

Via this blog, I would like to clearly establish that this is THE ONLY platform I communicate directly to my regular and potential clients and DO NOT own any email other than the ones I regularly use for my communication: meokhan2/at/g/mail/dot/com and meokhan/at/meokhan/dot/com. I have only one website that is my website. I am NOT associated with any company whatsoever.

It has all started very recently though I have had a few alerts in the recent past too. The major reason is my regular visits to different forums where I post on a number of academic-writing-related issues.

Some writers (most probably scam writers from dubious background) have tried to use my name from there and communicate to students, professionals, and other relevant clients by falsely representing as either myself or someone associated with me. That's just a No-No from me.

What comes NOT as a surprise is that they were able to locate my social media presence; it is quite convenient to guess that by this way they were able so access contact details of a number of people connected to me.

Hence, I am sorry but I am putting all my social media portals to a private status and would not be communicating much from there.

However, with this blog and my website, my Google Plus page would be active for you to place any inquiries, messages, or reach me for communication purposes.

I repeat: I DO NOT use any other email addresses other than the 2 mentioned on this page, nor do I run/manage/own a Facebook profile/page, or Google+ other than the ones I have already communicated to you.

Second, I DO NOT OFFER my writing services on any other forum.

LAST: kindly, do confirm from me if you receive any such messages. I would be obliged if you could share with me the communication history/details you have had with that person using my name libelously.

And please, do reach me for an inquiry in regards to your academic writing/research needs. I'd be honored to respond to you.

Regards
MeoKhan