To what extent does successful workplace learning depend on the social Essay

To what extent does successful workplace learning depend on the social context of the workplace environment - Essay Example This allows the organization to reach the potential growth and success that the organization dreams for. But to transform just a mere dream into reality, the organization must implement learning processes that would change the direction of the organization. This change in direction could change the future of the organization and its employees. As workplace learning is creating sustainable new knowledge, it is considered as an investment by the organization for their most important assets which is the workforce. The workforce could single handedly change the future of the organization, all they need is a training and development program but a program within the boundaries of organizational culture. An organization is a mixture of diverse culture and employees. The only element that combines these diverse employees from different race, religion and origin is the organizational culture. With the passage of time, organizations have become more cultural diverse and they have hired employe es belonging from different cultures and geographic locations. Although, this has been helpful for the organization as it has allowed organization to have diverse thinking and more creativity and better learning from different cultures.... Along with that, the research has highlighted some of the important dimensions that would include the definition of workplace learning, social context of workplace environment and lastly the impact of social context on successful workplace learning. A brief conclusion is also included to summarize and conclude all the major findings of this study. Successful workplace learning Workplace learning is a process that addresses the needs and interests of the employees. This learning process enables the employee to respond to the changing environment and to contribute in increasing the efficiency and productivity of the employee (Lai, and Lo, 2008). This learning process ultimately helps in meeting the employee’s personal and career development needs within the organization (Chen, Bian, and Hom, 2005). Learning at work allows the organization to develop different capabilities and skills and thus it is better able to achieve competitive advantage (Hamlin, and Stewart, 2011). Learning at work happens through the daily working practices of the workers and the biggest influence in this learning process is the work itself. A process that addresses the needs and interests of the employee helps in reducing the absenteeism rate, turnover rate, job dissatisfaction and all those factors that reduce the optimum performance to achieve the organizational goals. Successful workplace learning provides an opportunity for the employees of the organization to develop or improve their skills that would enable them to obtain the best possible outcomes for the business (Clarke, 2005). Employees are worthy investments for organizations as these employees are relied heavily upon for the success and betterment of the organization. Employees are considered to be the most valuable asset within

How does diversity of employment affect the welfare(income per person) Dissertation - 2

How does diversity of employment affect the welfare(income per person) in cities of America - Dissertation Example More emphasize should be placed on authenticity of variable like population, age and income of people to attain a reliable result from the research. The sample quantity also should be enhanced to enable a full fledged assessment of the coastal and non- coastal cities as to their contribution to per capital income. Additional independent variable also should be included to get accuracy and efficiency in the statistical models. Also, efforts should be made to cover more population among the cities so as to deliver a believable outcome .It is observed that people in both cities with higher educational level influenced in increasing the average income of the cities.. Finally it can be estimated that more than economic diversity, the educational level and age of individuals have more effect in increasing the per capital income and wealth of a city. Work Cited Khan, M.Y. (2008).Financial services. New Delhi: Tata McGraw Hill.

God's Omniscience and Human Free Will - Contradiction Essay

God's Omniscience and Human Free Will - Contradiction - Essay Example Most of the solutions or arguments are aimed at working around the problem rather than resolving it. I believe that there is no way to solve this conflict without denying either God’s omniscience or the existence of free will. In this essay I argue and attempt to prove that God’s omniscience and human free will are not compatible with each other. Omniscience in the simplest form is defined as the knowledge of everything, infinite or complete knowledge. That is, an omniscient God knows and has knowledge of everything, including what is going to happen in the future1. Human free will on the other hand is defined as the ability, power or force of a person to choose what or what not to do. In a more religious sense it is the ability or power to choose or turn away from good or evil2. Hence, definition of omniscient God implies an all knowing God meaning that God knows what is going to happen in the future. If God already knows what we are going to do in the future, it means that our actions are already predetermined and we have no control over the actions that we are going to take in the future. ... God is omniscient or humans have free will, both cannot be possible. Now let’s consider some of the solutions offered to solve the above conflict and see if it actually attempts to prove the compatibility of the two ideas or not. One of the major arguments made by those supporting omniscient God and human free will is that God’s foreknowledge in no way restricts human free will. That is, foreknowledge does not imply causality. Following analogy is used to support the claim: Sun rises tomorrow and knowing this does not cause the sun to rise. Knowing ahead of time does not restrict or cause an event to occur. Similarly, God’s foreknowledge of what we are going to do does not affect our free will to choose what we are going to do. It just means that God happens to know ahead of time what we are going to choose freely. God does not affect our freedom to choose but he simply knows ahead of time that what we are going to choose3. For this argument to work the concept o f time as we know it must be discarded. God is not restricted by the concept of time as we do. To God past, present and future exists at once, i.e, God exists outside of time. The above argument does not make logical sense and can be termed invalid. Let’s assume that humans have free will and are free to choose what they want to do. If an option A is chosen then by the earlier argument God would have known that option A would be chosen ahead of time. If instead of option A, due to free will, option B is chosen then the argument would be that this is what would have been known4. So either way the conclusion that can be drawn is that the future is determined. Irrespective of causing the event to occur or not, the future remains determined in the analogy used. Knowing that the sun

Ideal Leader Essay Example | Topics and Well Written Essays - 500 words

Ideal Leader - Essay Example They have a tendency to learn fast from their mistakes and take different actions to produce different results. Common people keep on repeating the same action expecting a different result. stick to the tried and tested formulas even if they think that something else might work better. Society has a tendency to follow the age old practices and rules without really thinking about their results. Even if they think that the things going on are wrong and unfair, they do not have guts to raise their voice against it and take responsibility for that. They fear the repercussions of going against the authority. Leaders take the decisions on the behalf of all the people who he is leading. When leaders take a decision, they are well aware of the fact that their decisions are going to affect the lives of all the people who they are leading. This is a huge responsibility to bear. However, they are not scared of shouldering this responsibility (Fairholm 2000. p. 66). Society if full of people who follow the rules, thinking patterns and social practices that are set from ages together. They hardly question the injustice and the bias towards people of particular ethnic background. Raising a voice against the social injustice means going against the ancestors and the authority that supports those rules. It is like going against the orthodox religious practices and government rules. This could mean punishment, criticism from the authoritative figures and isolation by the society. However, leaders are not afraid of it. They know what they are doing is right and no threat can suppress them from taking the action against it. People who dare to talk against the traditional practices are often alone in their journey

Progressive Era through the Great Depression Research Paper

Progressive Era through the Great Depression - Research Paper Example However, considerable achievements were realized during the period of the Great Depression. Examples of theses said gains are the establishment of the UN Commission on women status (Pierre, 2000). These movements fashioned the foundation for the current advances in women rights that are being witnessed in the current society. The second event this paper will expound is the stock market crash of 1929. The crash has been often cited as among the worst stock market crash in the history of United States. Its impact was so massive; it took the American economy approximately ten years to recover from this fallout. This stock market crash was preceded by a nine year steady rise of the American economy. The magnitude and implications of this crash warrants its classification as a significant turning point in the period of discussion. 2) 911 attacks and Terri Schiavo The current America society has witnessed several turning points, be it in the economic, political or cultural perspective. How ever, none rivals the power of the September Eleven attacks as a turning point. These attacks, more than ever, brought to the public light the vanity of American national security forces. It demonstrated just how susceptible the American people were to foreign attack. These attacks instigated radical reforms to the American government and subsequently the introduction of comprehensive security measures (Lionel, Baron & Murray, 2005). ... Terry Schiavo was left to die of starvation and dehydration that culminated in her bleeding to death (Randall, 1998). It is an appalling act that has put the human rights advancement in jeopardy. This single incident has the power to portray Americans as people with complete disregard for human life. Terry Schiavo was a responsive woman whose state of incapacitation signed her death warrant. The extent of public outcry that followed her death depicts the extent to which this was a gross act of negligence (Randall, 1998). 3) Why western states first There exists no substantiated assertion as to the reason why western states were more accepting of women suffrage as compared to their eastern counterparts. However, there are some claims that appear to be more logical than the rest. The western states had more male mortality rates as compared to the eastern regions (Thomas, Hall & David, 2009). As such, women were forced, by circumstances, to adopt a more assertive role in their lives. As such, they put themselves in the frontier. This then necessitated their suffrage to be accepted if the western states were to survive. An additional elucidation can be sourced from the relative lower women demographic as compared to the eastern states. The eastern states could afford to dominate their women as they were plenty in supply. However, the western states did not have this luxury. Therefore, they had to institute reforms that would entice the female population to migrate into their region. These reforms majorly included the creation of an enabling environment for women suffrage. This rationale is the more logical one in the class of

Paper-Based Versus Electronic Medical Record Keeping Essay Example for Free

Paper-Based Versus Electronic Medical Record Keeping Essay For many years, physicians’ offices documented all data in paper-based medical charts. Now, the physician or clinician records the medical data into a computer. Information stored in this manner is known as an electronic-based medical record or EMR. By definition, an EMR is a computerized record of the important health information regarding a patient including the care of that individual and the progress of that patient’s condition (Bonewit-West, Hunt, Applegate, 2009). The use of computers in physicians’ offices is not new. For decades, physicians have used computers and practice management software primarily to schedule appointments and for billing. The government has offered physicians incentives designed to encourage the adoption of electronic medical records to promote medical information accessibility, better patient care, greater efficiency, and financial savings (Hamilton, 2010). In the face of advancing technology, small medical offices must compare the cost, ease of use, and maintenance of electronic medical record systems versus paper-based record keeping. The cost of keeping paper-based and electronic medical records is not just about the actual price tag of the record-keeping systems. The cost of keeping an electronic medical record system (EMR) begins with the initial purchase and implementation of the hardware and EMR software. There are also ongoing maintenance expenses, loss of revenue associated with temporary loss of productivity due to converting paper charts to electronic ones, and the training of the staff (Menachemi Collum, 2011). The way these record systems are stored is very different and can greatly affect the cost as well. EMR records are stored on a server, digitally, in a secure computer database within the office practice (Hamilton, 2010). On the other hand, the cost of keeping a paper-based medical record requires certain supplies. File folders, folder labels, chart dividers, paper, and writing instruments are needed. Shelves are commonly used to hold and organize the charts for ease of accessibility by the staff. A growing medical practice may often require many shelving units that take up valuable office space. Storage boxes are required to store outdated charts or charts no longer in use (Bonewit-West et al., 2009). If there is not enough space in the office, then physicians may often have to pay for off-site storage (Hamilton, 2010).  The process of using a paper-based medical record system is relatively easy. However, there are some factors to consider. To use a paper chart, the medical staff must locate and retrieve it, make sure the appropriate documents accompany the chart, and have it ready for the physician. The physician or the medical staff must allocate enough time to accurately document the chart for each patient. Any chart, whether it is paper or electronic, needs to be comprehensible, so clear writing is imperative when recording using a paper chart (Bonewit-West et al., 2009). Meanwhile, using an EMR system requires the use of a computer. This can be a desktop model, laptop, or a tablet type device. The patient records are kept digitally within the EMR system and are accessed via the computer. This type of record-keeping system does not require the addition of paper documents. Al l paper documents are scanned into the EMR system or electronically obtained from other pertinent sources. Once paper documents are scanned into the EMR system, they become part of the patient’s permanent record and are no longer needed. This process requires EMR training of the medical staff, which is normally performed by the vendor supplying the EMR software. The physician and the medical staff must learn how to operate the new system and acclimate to the new paperless charting method. Learning an EMR program and using it with ease can take several months or more (Bonewit-West et al., 2009). The ease of use with both of these systems differs in the fact that paper-based records need to be filed properly in order to locate them when needed. Filing can be very time-consuming and paper-based records can be easily lost or destroyed. Even though electronic records are stored digitally on a server within the medical office, the medical staff will still need to enter the patient data into the EMR system. Electronic records need to be backed up daily because they can be lost due to fail ure of the hardware (Hamilton, 2010). Regular maintenance is required for both paper-based and electronic record keeping. The maintenance differs greatly between the systems and is ongoing regardless of which system is being used in the medical office. The routine maintenance of an electronic medical record system requires hiring network professionals to monitor and maintain the network. Some examples of maintenance tasks may include performing data backup once every twenty-four hours, storing a database backup offsite, and  archiving backup media once every month. There is also maintenance on the hardware and software. Hardware must be replaced and software will have to be upgraded regularly. A product specialist may need to run utilities for different applications within the EMR system. There will be ongoing training for all users of the electronic medical records system (Menachemi Collum, 2011). In contrast to electronic medical records, maintenance of paper charts require that they are examined periodically to make sure the chart remains in good condition since these charts will become worn over time. The charting of each patient should be complete, legible, and performed in a timely fashion. Paper charts that are outdated, that are deemed inactive or charts of patients who expired will have to be placed in boxes and put into storage (Hamilton, 2010). There are vast differences between paper-based and electronic medical record-keeping systems. One system is entirely manual while the other requires manual data entry combined with computerization. For decades, physicians and staff of medical practices have used only the manual or paper-based method of keeping medical records. Change can be costly and frustrating, but with the advancement of technology, coupled with the government requiring the use of EMR, small medical offices must explore the cost, ease of use, and maintenance involved in making this important change in the way of keeping medical records. References Bonewit-West, K., Hunt, S. A., Applegate, E. J. (2009). The medical record. In Todays Medical Assistant: Clinical Administrative Procedures. St. Louis, Mo: Saunders/Elsevier. Hamilton, B. (2010). Electronic health records (2nd ed.). New York, NY: McGraw-Hill Higher Education. Menachemi, N., Collum, T. (2011). Benefits and drawbacks of EHRs. Risk Management and Healthcare Policy, 4, 47-55. Retrieved from doi:10.2147/RMHP.S12985.

Quantitative Research in Patient Safety Literature Review

Quantitative Research in Patient Safety Literature Review Recently, research has occupied a crucial place in nursing that is identified as â€Å"the diagnosis and treatment of human responses to actual or potential health problems† (American Nurses’ Association, 1980 p.9); thus, an appropriate understanding of research literature is a prerequisite for every individual who works in this area (Rees, 2003). Unfortunately, despite the fact that most of nurses acquire specific skills in research, only some of them manage to apply research data or research findings to practice (Bostrum Suter, 1993). This can be explained by the nurses inability to critique a research, evaluating its pros and cons (Krainovich-Miller et al., 2002). The aim of the present essay is to critically analyse two quantitative research literatures in patient safety. The first research is â€Å"Relationship between complaints and quality of care in New Zealand: a descriptive analysis of complainants and noncomplainants following adverse events† by M. Bi smark et al. (2006), while the second research is â€Å"Comparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals† by P. Michel et al. (2004). Although many nursing studies have been conducted in the last decade (e.g. Johnson Lauver, 1989; Conlon Anderson, 1990; Norman et al., 1991; Brennan et al., 1995; Gross et al., 1995; Fieler et al., 1996; Bennet, 1999), they implicitly dealt with the issues of patient care; however, the studies discussed further directly relate to the quality of medical care in New Zealand and France. The research conducted by Bismark et al. (2006) evaluates the extent of injuries in the patients cured in public hospitals of New Zealand, or more precisely (as the title reveals), a correlation between patients’ complaints and quality of medical care. While the title is clue to the focus, the abstract gives more detailed information, identifying the major aspects of the research (objectives, design, setting, population, main outcome measures, results and conclusion) in a clear scientific style. However, the abstract does not indicate the research questions of the study; they are stated further in the research and are the following: 1) Do complaints track injuries, or are they prompted by more subjective concerns? 2) Are complaints the â€Å"tip of the iceberg’ in terms of quality of care problems and, if so, how representative are they of broader quality problems? (Bismark et al., 2006 p.17). Although the research by Michel et al. (2004) also refers to patient safety, neither the title, nor the abstract uncovers the theme in an explicit way. Actually, the theme is exposed further in the research; in particular, the study analyses rates of unintended injuries (defined by the authors as adverse events and preventable adverse events) in the patients cured in care hospitals of France. Similarly to the first research, the abstract in the second study briefly summarises the research and is divided into the same categories that uncover the essence of the investigation. In this regard, the abstract is an obvious strength of the analysis and it can serve as an example to other researchers who investigate various aspects of nursing. But the research does not specify the research questions either in the abstract or in the introduction section of the paper. Such a lack of specific questions certainly complicates the overall apprehension of the study. The authors could have proposed some research questions, such as 1) What are the major aspects of reliability, acceptability and effectiveness? Or 2) How rates of adverse events and rates of preventable adverse events can be properly assessed with each of three methods? These questions are of primary importance to the research, as adverse events and preventable adverse events can not be rightfully evaluated, if the major criteria of reliability and effectiveness are not properly discussed in the context of the research. However, the authors pay little attention to these aspects of the analysis. Despite the fact that the introduction section in both studies provides a valid explanation of the importance of the problem, neither of the two studies includes an overview of the previous research or specific reports. This neglect decreases the overall presentation and reduces the value of the presented data. However, the problems of statement are formulated in a concise way and reflect that the researchers narrowed the areas of research to the issue of adverse events in the clinical setting in order to get more accurate findings. In fact, this issue is especially relevant today when patient safety has become worse in many countries of the world. The justification for the chosen topic in the research by Bismark et al. (2006) is that the recent accident compensation system in New Zealand does not adequately examine patients’ complaints in all cases of adverse events. Pointing at the fact that â€Å"there is growing international interest in harnessing patient dissatisfaction and complaints to address problems with quality† (Bismark et al., 2006 p.17), the authors concurrently put crucial questions that inspire readers’ interest in the issue of patient safety from the very beginning. In the research of Michel et al. (2004) the underlying reason for initiating an investigation is that the limitations of the employed methods reduce the validity of the received findings in regard to patients’ injures within the hospital setting. However, the lack of appropriate background, theoretical frameworks, hypotheses and definite aims in the introduction section considerably limits the studies. This especially regards the non-inclusion of specific theories that usually back up the presented data. In this respect, both studies are theory-free; unlike theory-testing research and theory-generating research, this kind of research is less popular because it does not analyse any theoretical concepts that constitute the basis of practical nursing. On th e other hand, the studies of Michel et al. (2004) and Bismark et al. (2006) specifically focus on a practical problem-solving framework; that is, the present researches are aimed at identifying practical solutions to the discussed problems rather than discussing theoretical implications. The research of Michel et al. (2004) uses a quantitative research method that â€Å"emphasizes objectivity through statistical analysis† (Santy Kneale, 1998 p.77) and the quasi-experimental design that is considered to be more adequate and less biased than an experimental method, if an investigation is conducted within the clinical setting (Polit Hungler, 1995). Though objectivity is crucial for such kind of research, it would also be appropriate to combine quantitative and qualitative methods, that is, to combine objectivity and subjectivity (Phillips, 1990). The fact is that due to its quantitative method the study appears to be too analytical, too objectively-oriented; thus, there is a necessity to introduce some aspects of the subjective realm into the research. However, Parahoo (1997) supports another viewpoint, exposing the inadequacy of a qualitative method, especially in regard to a nursing research. The author points out that, applying to a quantitative method, rese archers are able to predict the final outcomes, while a qualitative method may generate unpredictable results. The data in the study are collected in care hospitals of Aquitaine with the help of three research techniques – a cross sectional method, a prospective method and a retrospective method. Such triangulation is aimed at â€Å"relat[ing] different sorts of data in such a way as to counteract various possible threats to the validity of analysis† (Hammersely Atkinson, 1983 p.199). In the present study triangulation corresponds with the terms of reference that provide appropriate relevance to the whole research (Shih, 1998). Identifying both advantages and disadvantages of all three methods in Box 2, the researchers contribute much to the reliability of the findings, despite the fact that they have not conducted a pilot study that, according to Carr (2003), intensifies the credibility of the employed research techniques. On the other hand, a pilot study is crucial for the investigations that utilise unchecked tools for research, as is the case with the present study, where the researchers conduct an evaluation of methodology. In this regard, a pilot study â€Å"helps to illuminate some of the problems of the research tool† (Santy and Kneale, 1998 p.80). The research of Bismark et al. (2006) is also quantitative with descriptive design. The baseline data are taken from the medical records of the New Zealand Quality of Healthcare Study (NZQHS) and the Commissioner’s complaints database. Further, multivariate and bivariate analyses are applied to the research to identify certain dissimilarities between complaints and non-complaints. Overall, the explanation of the research techniques and methods is a great strength of this study, as the authors provide a thorough description in regard to data collection and study design. Although the researchers do not define a hypothesis of the analysis, they, nevertheless, use dependent and independent variables to differentiate complainants from non-complainants. However, the limited space of both studies has not allowed the researchers to insert the samples of medical records and questionnaires that served as the basis for the research; thus, the methodology of both investigations can not be fully assessed in terms of the quality. Actually, the research of Bismark et al. (2006) and the research of Michel et al. (2004) employ primary sources (including official records) that explicitly relate to the subjects. But according to Burgess (1991), even primary sources should be critically assessed and â€Å"it is essential to locate them in context† (p.124). But neither the first nor the second study provides a critical evaluation of the utilised sources. In regard to ethical issues, they are not openly addressed in the studies; however, in the research of Bismark et al. (2006) there is a mentioning that the investigation was endorsed by the Wellington Ethics Committee. For Robinson (1996), such ethical approval is a necessary part of a nursing research, as any investigation deals with human beings who may experience certain difficulties during the research. On the other hand, due to its descriptive nature the present study does not necessarily need an informed consent or ethical considerations (Cutcliffe Ward, 2003), while the research of Michel et al. (2004) requires a discussion of certain ethical issues because of its quasi-experimental design. Some of these issues are patients’ confidentiality, defence of their rights and risk control (Pranulis, 1996). In regard to the latter factor, it is necessary for researchers to increase potential benefits and decrease potential risks, especially in such studies that involve a great number of participants, as is just the case with the research of Michel et al. (2004). Thus, it would have been proper for the researchers of the present study to discuss in detail subjects’ conditions and potential harm, particularly in view of the fact that nursing directly relates to patient safety within the clinical setting (DHHS, 1981). However, the ethical rights of samples are implicitly defended in both studies, as no personal details of participants are revealed. But the researchers provide no information of the ways the data were stored and protected before or during the investigation. Similarly, neither of the studies refers to informed consents, while this is a prerequisite for any nursing research (Alt-White, 1995; Berry et al., 1996). As for sampling, the study of Bismark et al. (2006) analyses two groups of patients: the first group includes people who made complaints to the Commissioner and the second group includes people â€Å"identified by the NZQHS as having suffered an adverse event who did not lodge a complaint† (Bismark et al., 2006 p.17). A two stage sampling process is initiated by NZQHS on the example of 6579 medical records. Although inclusion and exclusion criteria are not explicitly identified in the study, the researchers make it clear that they only choose the patients who suffer adverse events. In the process of analysis these patients are divided into two categories – complainants and non-complainants, though both groups are typical representatives of the larger population. In the research of Michel et al. (2004) the sampling includes 778 patients from medical, surgical and obstetric wards. This number of samples is appropriate for a descriptive study. Initially, the researchers chose 786 patients with the help of a two stage cluster stratified process, but excluded 8 persons â€Å"because they were still present on day 30, precluding the review of their medical records† (Michel et al., 2004 p.2). In this respect, the study does not clearly define inclusion and exclusion criteria, but some samples are excluded in the process of investigation. No obvious bias is found in regard to the samples; similar to the previous research, the samples belong to typical representatives of the larger group. In view of this fact, the sampling can be considered as fully reliable. In addition to authors’ comments, the results in the research of Bismark et al. (2006) are presented in figures, tables and boxes that are introduced as additional tools for clarification. This visual information reflects how the data are collected and measured (Figure 1 is especially accurate in revealing the cases of injured complainants and non-complainants). Although the authors do not specifically explain such a choice, they provide a detailed justification for the use of correlation tests that define dependent variables (a distinction between complainants and non-complainants) and independent variables (age, ethnicity, sex and other factors). Besides, the researchers weight the bivariate and multivariate analyses to acquire more accurate findings. The results in the study of Michel et al. (2004) also appear in both textual and graphic forms in order to enhance explanation. But the researchers do not attain the balance between figures and comments, putting too much emphas is on figures. Unlike the previous study, the authors do not use dependent and independent variables in their analysis; however, they employ paired X2 tests for the comparison of retrospective and prospective methods. Discussing their findings, Bismark et al. (2006) draw a parallel between the received results and the findings of the previous studies. Actually, many findings of the prior research are consistent with the present research (e.g. Burstin, et al., 1993; Studdert et al., 2000), while some findings contradict the earlier results (e.g. Tapper et al., 2004). To some extent, such a comparison justifies the lack of literature review at the beginning of the research and provides more validity to the overall outcomes. In general terms, the findings of Bismark et al. (2006) directly relate to the objectives of the study, gradually introducing the evidence that proves the authors’ initial suggestions. In particular, the researchers find out that 79% of all injures can be identified as preventable adverse events. In the case of the Commissioners analysis, 64% of the complaints are made by the patients who suffer adverse events, of which 51% are preventable adverse events. In regard to the NZQHS review, 315 cases of adverse events (out of 850 cases) are preventable, 124 cases are serious and 48 cases are serious and preventable. As for instigators of complaints, 41% of complaints are made by the patients, while 59% by their relatives or friends (13% spouse, 16% parent and 17% child). Evaluating the independent variables, the researchers reveal that the age of complainants is lower than the age of non-complainants; moreover, non-complainants mainly live in the regions with poor economic conditions. The findings in the research of Michel et al. (2004) also relate to the terms of reference, providing evidence that â€Å"the prospective method has several advantages over retrospective and cross sectional methods† (Michel et al., 2004 p.3). In particular, the prospective method better recognises preventable adverse events and is more trustworthy than two other methods. This is clearly seen in Venn diagrams that demonstrate the number of adverse events identified by each of three research methods. Overall, the findings in the present study are not properly discussed; however, the researchers discuss in detail the strengths and limitations of the research in the discussion section. For instance, as the authors reveal, reliability and effectiveness of adverse even ts rates are successfully estimated because the samples are assessed with the help of three methods. On the other hand, the researchers point at the possibility of bias that â€Å"may have been present due to the small number of hospitals and wards† (Michel et al., 2004 p.3) and because of the participation of the care teams in the prospective method. Besides, the reference list that the researchers utilised in the process of investigation might have errors that were not identified. Finally, the aspects of reliability, effectiveness and acceptability are not discussed in detail by the authors, though these are the major assessment criteria of the study. However, there are some obvious strengths of the research; unlike the studies that analyse adverse events either in surgery or medicine (e.g. Mantel et al., 1998; Waterstone et al., 2001), the present study examines various cases of adverse events in three areas – medicine, surgery and obstetrics. Similarly to this research, Bismark et al. (2006) also identify certain limitations of the study; in particular, the analysis of adverse event rates is rather confined, if medical record reviews serve as the basis for the research. The research also lacks definite ethnicity data for all complainants; thus, there is a â€Å"potential for measurement error† (Bismark et al., 2006 p.21). In addition, the authors do not provide any information as to the alternative research methods that can be used for the assessment of the relations between complains and quality of medical care. Drawing a parallel between the employed methods and the alternative methods, it will be possible to enhance the validity of the received findings. The conclusion in the research of Bismark et al. (2006) directly responds to the terms of reference; based on the received results, the conclusion suggests that elderly or economically poor patients rarely initiate complaints processes. The same regards the pati ents who belong to ethnic minorities (in this case – to Pacific ethnicity). The authors recommend to conduct a further study that will profoundly investigate the reasons for people’s refusal to make complaints in the cases of poor medical care. Moreover, the complaints greatly depend on the severity of injures and whether the event is preventable or unpreventable. In this respect, as the researchers conclude, â€Å"complaints offer a valuable portal for observing serious threats to patient safety and may facilitate efforts to improve quality† (Bismark et al., 2006 p.22). Unfortunately, no recommendations for practice are made at the end of the study, thus reducing the relevance of the received findings. On the other hand, as Santy and Kneale (1998) claim, â€Å"all research has some implications for practice even if the results have proven to be inconclusive† (p.82). In the research of Michel et al. (2004) the conclusion summarises the results that, in the authors’ words, â€Å"provide new insights into the epidemiology of adverse events† (p.4). Such a viewpoint is explained by the fact that the findings of the present study reveal the ways to intensify the implementation of prospective assessment in the clinical setting. However, the researchers only suggest the answers to the posed questions, avoiding any insisten ce on specific concepts or notions. Comparing three methods, the researchers recommend to use the prospective method for different purposes that implicitly or explicitly relate to the evaluation of adverse events rates. Finally, Michel et al. (2004) briefly discuss the prior knowledge on the topic and the knowledge acquired in the process of investigation. In regard to the prior knowledge, the assessment of adverse events was conducted in an analytical way that considerably limited the findings. In the present study the researchers receive more feasible results and identify that the causes of adverse events and risk reduction programmes can be successfully evaluated by the prospective method rather than by the retrospective or cross-sectional methods. However, further research is required, if the evidence received in this research is applied to practice (Barron Kenny, 1986; Scott Thompson, 2003). Overall, both researches are well-structured and are written in a scientifically concise style; however, as was stated above, the study of Michel et al. (2004) provides too much technical details, while analysing the results. Therefore, it is slightly difficult to read the research and, consequently, there is a chance that its findings may be ignored by a practitioner on the premise of misunderstanding. Although the research of Michel et al. (2004) is logically constructed, an unqualified person may fail to rightfully apprehend the presented data. On the contrary, the study of Bismark et al. (2006) is easy to understand because it lacks much unexplained jargon. Another strength of the research is the appropriate use of quotes in the discussion section; these quotes are directly related to the analysis and correspond with the ideas expressed by the authors, either refuting or confirming them. Employing this or that quote, the researchers provide a detailed interpretation of a certain concept; and for all that, the number of quotes is reasonable and they are rather short. On the contrary, Michel et al. (2004) do not utilise quotes in the discussion to support their arguments, though they use certain references. Despite the fact that the researchers do not explicitly recommend their studies to nurses, the overall findings can be especially relevant to nursing staff, as well as to the researchers who are involved in health care. Within a complex clinical setting nurses experience various difficulties because of the lack of appropriate practical knowledge (Treacy Hide, 1999; Polit et al., 2001). Thus, the studies of Michel et al. (2004) and Bismark et al. (2006) can inspire nurses’ interest in the ways of patient safety, as, despite their limitations and certain inadequacies, the studies pose vital questions that may increase the quality of medical care not only in France and New Zealand, but in other countries as well. Due to the fact that nowadays nursing staff is usually required to implement various aspects of research into practice (Christman Johnson, 1981; Burnard Morrison, 1990; Street, 1992; McSherry, 1997; Cormack, 2000; Rodgers, 2000; Hek et al., 2002; Cluett Bluff, 2004), the present studies are especially valuable, as they provide useful and valid information that extends the prior knowledge in patient safety. 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