Evidence Based Practice In Nursing

INTRODUCTIONResearch studies are conducting all over the world, throughout the year . Research is conducted to improve the existing practices. If the study findings are implemented to practice only , the study is effective. Evidences getting from the study which are utilized into practice makes the profession more fruitful, bright and effective. Most nurse researchers want their findings to contribute to nursing practice and there is growing interest among nurses in basing their practice on solid research evidence RESEARCH UTILIZATION IN NURSING The terms research utilization and evidence based practice are used synonymously.Although there is overlap between these two concepts they are in fact distinct. Research Utilization is: â€Å"A process of using findings from conducting research to guide practice† (Titler, Mentes, Rake, Abbott, and Baumler, 1999). â€Å"The process by which scientifically produced knowledge is transferred to practice† (Brown, 1999) DIFFERENCES: N urses should not confuse EBP [Evidence Based Practice] with research utilization. While research utilization overlaps with some of the same philosophic threadworks of EBP, EBP goes beyond just the rigorous scientific research steps.Research Utilization refers to the review and critique of scientific research, and then the application of the findings to clinical practice. Evidence-Based Practice (EBP) represents a broader concept. When clinicians use the EBP approach, they go beyond the expertise of clinicians and researchers, and consider the patient's preferences and values to guide patient care. THE RESEARCH UTILIZATION CONTINUM The start point of research utilization is the emergence of new knowledge and new ideas. Research is conducted and over time knowledge on new topic accumulates.In turn knowledge works its way to use to varying degrees and different rates. Theorists who have studied the phenomenon of knowledge development and diffusion of ideas typically recognize a continu um in terms of the specificity of the use to which research findings are put At one end of the continuum are discrete , clearly identifiable attempts to base specific actions on research findings. . This type of utilization has been referred to as instrumental utilization. Research findings can be used in a more diffuse manner. In a way that promote cumulative awareness, understanding or enlightment.Caplan and Rich [1975] refer to this as the end of the utilization continuum as conceptual utilization. Conceptual utilization then refers to situations in which users are influvanced in their thinking about an issue based on their knowledge of studies but do not put this knowledge to any specific , documentable use. The middle ground of this continuum involves the partial impact of research findings on nursing activities. This middle ground is the result of a slow evolutionary process that does not reflect a conscious decision to use an innovative procedure but rather reflects what Weis s termed knowledge creep and decision accretion.‘ knowledge creep’ refers to an evolving percolation of research ideas and findings. ‘Decision accretion’ refers to the manner in which momentum for a decision builds over time based on accumulated information gained through informal discussions , readings , meetings and so on. Increasingly now a days nurses are making conscious decisions to use research in their clinical practice and the EBP movement has contributed to this change. Estrabooks [1999] studied research utilization and found evidence to support three distinct types of research utilization.Indirect research utilization: involving changes in nurses’ thinking and therefore analogous to conceptual utilization. Direct research utilization: involving the direct use of findings in giving patient care and therefore analogous to instrumental utilization. Persuasive utilization: involving the utilization of of findings to persuade [typically those i n decision making positions] to make changes in policies or practices relevant to nursing care.These varying ways of thinking about research utilization clearly suggest that both quantitative and qualitative research can play key roles in guiding and improving nursing practice The research utilization process; Rogers’ diffusion of innovation theory Rogers’ theory is one of the most accepted theories that has developed models of how knowledge gets disseminated and used. It has influvanced several research utilization projects in the nursing community. Rogers postulate that knowledge diffusion is an evolutionary process by which an innovation is communicated over time to members of a social system.The key elements in this process, all of which influence the rate and extent of innovation, adoption include the following, 1. The innovation is a new idea, practice or procedure that if adopted will result in changes the nature of innovation strongly affects the decision about adoption. 2. Communication channels are the media through which information about the innovation is transmitted and can include both mass media or individual face to face communication. Communication is most effective when there are shared believes , values and expectations on the part of the sender and receiver of information.3.  Time is component of theory in that the process of knowledge diffusion occurs over time. There are varying amounts of time that elapse between the creation of knowledge and its dissemination and between knowledge awareness and the decision to use or reject the innovation 4. The social system is the set of interrelated units that solve the problems and seek to accomplish a common goal. Diffusion occurs within the social system that vary in their norms and receptivity to innovations Rogers Characterized the innovation adoption process as having five stages knowledge, persuasion, decision, implementation and confirmation.During the knowledge stage individu als or groups become aware of the innovation and during the persuasion stage they form appositive attitude towards it. In the decision stage , a choice is made about whether to adopt or reject the innovation. The innovation is actually put into use during the implementation stage. Finally the effectiveness of the innovation is evaluated during the confirmation stage, and decisions get made about continuation or discontinuation of the innovation. Recent research on utilization has challenged the linear nature of the process Evidence-based practice.During the 1980s, the term â€Å"evidence-based medicine† emerged to describe the approach that uses scientific evidence to determine the best practice. Later, the term shifted to become â€Å"evidence-based practice† as clinicians other than physicians recognized the importance of scientific evidence in clinical decision-making. Various definitions of evidence-based practice (EBP) have emerged in the literature, but the most commonly used definition is, â€Å"the conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of individual patients† (Sackett, Rosenberg, Gray, Hayes, & Richardson, 1996).Subsequently, experts began to talk about evidence-based healthcare as a process by which research evidence is used in making decisions about a specific population or group of patients. Evidence-based practice and evidence-based healthcare assume that evidence is used in the context of a particular patient’s preferences and desires, the clinical situation, and the expertise of the clinician. They also expect that healthcare professionals can read, critique, and synthesize research findings and interpret existing evidence-based clinical practice guidelines.Definitions of research utilization, quality improvement, and nursing research Evidence-based practice is not research utilization, quality improvement, or nursing research, although it may be rela ted to each of these processes. For example, quality improvement projects may be evidence-based, and the findings may contribute to other EBP or research initiatives. Also, an evidence-based practice project can lead to a research study or quality improvement initiative. What is research utilization? For decades, nurses have used available research to guide nursing practice and their efforts to improve patient outcomes.This process involved critical analysis and evaluation of research findings and then determining how they fit into clinical practice. Incorporating pertinent research findings into clinical practice (and evaluating the changes’ effectiveness), helps close the gap between research and practice. More recently, research utilization efforts in nursing have been replaced by evidence-based practice, What is quality or performance improvement? Quality, clinical, or performance improvement focuses on systems, processes, and functional, clinical, satisfaction, and cost outcomes.Typically, quality improvement efforts are not designed to develop nursing practice standards or nursing science, but they may contribute to understanding best practices or the processes of care in which nurses are actively involved. A commonly accepted view is that quality improvement activities in healthcare are not intended to generate scientific knowledge but rather to serve as management tools to improve the processes and outcomes within a specific healthcare organization or setting.More recently, experts have focused on improving care by examining and working within clinical Microsystems or the specific places where patients, families, and care teams meet (Nelson, et al. , 2002). To improve and maintain quality, safety, and efficiency, clinical teams must blend analysis, change, and measurement into their efforts to redesign care within these clinical Microsystems. Quality improvement initiatives generally address clinical problems or issues, examine clinical processe s, and use specific indicators to help evaluate clinical performance.Data are collected and analyzed to help understand both the process and the related outcomes. The findings help contribute to efforts to achieve and maintain continuous improvement through ongoing monitoring and improvement activities. Quality improvement projects vs. research projects Many have asked whether quality improvement projects are the same as research projects—they are not. In clinical practice, these efforts may seem similar in that, for example, both may seek answers to clinical problems and use similar data collection and analysis methods.However, factors that may differ include participant or subject recruitment, the study’s methods, and how the results are used. For example, in most quality improvement activities, the participants generally are the patients within a specific clinical micro system. In research efforts, the investigator recruits human subjects using approaches that will ensure a representative sample of the population. In many improvement activities, the intervention may change as it is evaluated, whereas in a research study the treatment or intervention remains the same.Furthermore, in most quality improvement initiatives, the healthcare team is trying to solve a problem in a particular setting instead of trying to generalize the results of the study to other settings and populations. Although it might be helpful to learn about the activities and experience of other improvement teams, their findings may not apply to or be appropriate in other settings or patient populations. The intent of research, however, is to develop new knowledge that can be generalized to other similar populations and clinical settings.Despite the differences between research and quality improvement projects, however, one must consider the protection of human subjects in both. To ensure that you adequately protect the rights of patients or subjects, always ask an Institution al Review Board (IRB) to review the research proposal or quality improvement project before implementing the study and beginning data collection. Also note that, whether the effort is research or quality improvement, one goal may be to disseminate the results of the project in a published paper or oral report.For any dissemination project, address adequate human subject protection and adherence with the Health Information Portability and Accountability Act of 1996 (HIPAA) guidelines before beginning the improvement project or research study. Individuals involved in either quality improvement or research projects should seek advice from their organization’s IRB, privacy officer, and risk management department to ensure that data are managed in a manner consistent with any pertinent federal or state regulations and organizational policies and procedures..Multidisciplinary effort Within clinical settings, many such opportunities exist for both nursing and multidisciplinary impro vement efforts. Improvement activities for nursing can be as simple as reducing time in giving verbal report or improving compliance with documentation requirements. Multidisciplinary collaborative efforts may address complex health issues, such as the care of acute myocardial infarction patients or individuals with community-acquired pneumonia.These initiatives are becoming more important in acute care hospitals as the national focus on public reporting increases. Such efforts help consumers compare the quality of care that various hospitals provide. The Centers for Medicare & Medicaid Services (CMS); various organizations that represent hospitals, doctors, and employers; accrediting organizations; other federal agencies; and the public have combined efforts to develop Hospital Compare and, thus, have made key clinical outcome measures available to the public.In this way, the public can monitor performance indicators to related common medical conditions and certain evidence-based i nterventions that are consistent with achieving the best patient outcomes. Collaboration within multidisciplinary teams creates opportunities to address clinical problems and issues using various perspectives and expertise. Nurses play key roles in such efforts and often benefit from the synergy that can be realized by working with others interested in or concerned about the problem.The group can work together while measuring their progress against pre-determined objectives What is nursing research? Nursing research involves systematic inquiry specifically designed to develop, refine, and extend nursing knowledge. As part of a clinical and professional discipline, nurses have a unique body of knowledge that addresses nursing practice, administration, and education. Nurse researchers examine problems of specific concern to nurses and the patients, families, and communities they serve. Nursing research methods may be quantitative, qualitative, or mixed (i.e. , triangulated):†¢ In quantitative studies, researchers use objective, quantifiable data (such as blood pressure or pulse rate) or use a survey instrument to measure knowledge, attitudes, beliefs, or experiences †¢ Qualitative researchers use methods such as interviews or narrative analyses to help understand a particular phenomenon †¢ Triangulated approaches use both quantitative and qualitative methods Regardless of the method they use, researchers must adhere to certain approaches to ensure both the quality and the accuracy of the data and related analyses.The intent of each approach is to answer questions and develop knowledge using the scientific method. Examples of nursing research projects Examples of nursing research projects include the following: †¢ Randomized clinical trial examining best practice for orthopedic-pin site care †¢ Efficacy of examination gloves for simple dressing changes †¢ Reliability of methods used to determine nasogastric tube placement †¢ The effects of relaxation and guided imagery on preoperative anxiety †¢ Quality of life in patients with chronic pain†¢ The relationship of a preoperative teaching program for joint replacement surgery and patient outcomes The scientific method involves collecting observable, measurable, and verifiable data in a prescribed manner so as to describe, explain, or predict outcomes. For example, one might collect data to describe the effects of massage on blood pressure, explain decreased needs for sedation, or predict lower levels of anxiety. Research methods demand that the collected data remain objective and not be influenced by the researcher’s hypotheses, beliefs, or values.In the massage example, the researcher could easily bias the results by administering the massages or collecting the data. Using certain approaches to subject recruitment, performing faulty data collection, and not controlling for other confounding variables also can bias research findings. Therefor e, when developing a study proposal, the researcher must develop a plan that minimizes these risks and supports the development of reliable information and results. EVIDENCE BASED PRACTICE EBP begins with search for information about how best to solve the specific problems.Findings from rigorous research are considered the best possible source of information but EBP also draws on other sources. A basic feature of EBP is that it deemphasizes decision making based on custom, opinion of the authority, or ritual. Rather the emphasis is on identifying the best available research evidence and integrating it with clinical expertise, patient input and existing resources. EBP movement has both supporters and critics. Supporters say that EBP offers a solution to sustaining high health care quality or in our cost constrained environment.Their position is that a rational approach is needed for providing best possible care to most people, with most cost effective use of resources. Critics worry that the advantages of EBP are exaggerated and that individual clinical judgments and patient inputs are being devalued. TYPE OF EVIDENCE AND EVIDENCE HIERARCHIES Positions about what constitutes useful evidence have loosened, but there have been efforts to develop evidence hierarchies that rank studies according to the strength of evidence they provide.The most accepted hierarchy is given below 1. Meta analysis of controlled studies 2. Individual experimental studies 3. Quasi experimental studies [eg; time series, non equalant control group] or matched case control studies 4. Non experimental studies [eg; co relational studies , descriptive and qualitative studies] 5. Programme evaluations, research utilization studies, quality improvement projects, case reports 6. Opinions of respected authorities and expert committeesThe nine alternative sources include Bench marking data, Cost effectiveness analysis, Pathophysiologic data, Retrospective or concurrent chart review, Quality improv ement and risk data, international, national , and local standards, institutional data collected for infection control purposes, patient preferences and clinical expertise EBP implications for nurses Nurses serve instrumental roles in ensuring and providing evidence-based practice. They must continually ask the questions, â€Å"What is the evidence for this intervention? † or â€Å"How do we provide best practice?† and â€Å"Are these the highest achievable outcomes for the patient, family, and nurse? †Nurses are also well positioned to work with other members of the healthcare team to identify clinical problems and use existing evidence to improve practice. Numerous opportunities exist for nurses to question current nursing practices and use evidence to make care more effective. Nurses throughout the country also have been involved in multidisciplinary efforts to reduce the number and severity of falls and pressure ulcers/injuries. Such projects can help save m oney and improve care processes and outcomes.By implementing existing evidence-based guidelines related to falls and pressure ulcers/injuries, care has improved, and the number and severity of negative outcomes have decreased. Importance of evidence-based practice Evidence-based practice helps nurses provide high-quality patient care based on research and knowledge rather than because â€Å"this is the way we have always done it,† or based on traditions, myths, hunches, advice of colleagues, or outdated textbooks. Why is EBP important to nursing practice? †¢ It results in better patient outcomes †¢ It contributes to the science of nursing †¢ It keeps practice current and relevant†¢ It increases confidence in decision-making †¢ Policies and procedures are current and include the latest research †¢ Integration of EBP into nursing practice is essential for high-quality patient care often, nurses feel that they are using â€Å"evidence† to gui de practice, but their sources of evidence are not research-based In a study conducted by Thompson, et al. , (2003), nurses reported that the most helpful knowledge source was experience or advice from colleagues or patients. Of concern were reports that up-to-date electronic resources that included evidence-based materials were not useful to nurses in clinical practice.This barrier contributes to significant gaps in clinicians applying research findings to practice and dissemination of innovations. The failure to use evidence results in care that is of lower quality, less effective, and more expensive (Berwick, 2003). Evidence-based practice can be easier for nurses to use if they refer to already-developed evidence based or clinical practice guidelines. Numerous expert groups have already undertaken systematic efforts to develop guidelines to help both healthcare providers and patients make informed decisions about care interventions.Guideline developers use a systematic approach to critique the existing research, rate the strength of the evidence, and establish practice guidelines. The overall goal of these types of efforts focuses on guiding practice and minimizing the variability in care MODELS FOR EVIDENCE BASED NURSING PRACTICE During the 1980,s and 1990’s a number of different models of research utilization were developed. These models offered guidelines for designing and implementing a utilization project in a practice setting. The most prominent of these models were the Stetler model and The Iowa model.These two models were updated to incorporate the EBP process rather than research utilistion alone. THE STETLER MODEL The Stetler model of research utilization was designed with the assumption that research utilization could be undertaken not only by organizations , but by individual clinicians and managers. It was a model designed to promote and facilitate critical thinking about the application of research findings in practice. The updated and refined model is based on many of the same assumptions and strategies as the original but provides an enhanced approach to the overall application of research in the service setting.The current model involves five sequential phases 1. Preparation ;- in this phase the nurse defines the underlying process, purpose and outcome of the project ; search, sort, and select sources of research evidence; consider the external factors that can influence potential application and internal factors that can diminish the objectivity and affirm the priority of the perceived problem. 2. Validation ;- This phase involves a utilization focused critique of each source of evidence focusing in particular on whether it is sufficiently sound for potential application in practice.The process stops at this point if the evidence sources are rejected. 3. Comprehensive evaluation and decision making ;- this phase involves the synthesis of findings and the application of four criteria that , taken together are used to determine the desirability and feasibility of applying findings from validated sources to nursing practice. These criteria include Fit for setting:- Similarity of characteristics of samples to your client population. Similarity of study’s environment to the one which you work FeasibilityPotential risk for implementation to patients, staff and organization Readiness for change among those who would be involved in a change in practice Resources requirements and availability Current practice Congruency of the study with theoretical basis for current practice behaviour Substantiating evidence Availability of confirming evidences from other studies Availability of confirming evidences from Meta analysis or integrative review The end result of comprehensive evaluation is to make a decision about using the study findings. If the decision is a rejection, no further steps are necessary4.  Translation/ Application;- this phase involves activities to Confirm how the findings w ill be used formally or informally Spell out the operational details of application and implement them. It involves the development of a guideline, detailed procedure, or plan of action, possibly including plans for formal organizational charge. 5. Evaluation:- in this final phase the application is evaluated. Informal use of the innovation versus formal use would lead to different evaluative strategies.Although the Stetler Model originally was designed as a tool for individual practitioners, it has also been the basis for  formal research utilization and EBP projects by group nurses. THE IOWA MODEL Efforts to use research evidence to improve nursing practice are often addressed by groups of nurses interested in the same practice issue. Formal EBP projects typically have followed systematic procedures using one of several models that have been followed systematic procedures using one of the several models that have been developed, such as The Iowa Model of the research in practice . The model was renamed as Iowa Model of Evidence Based Practice to Promote Quality Care.The current version of the Iowa Model acknowledges that a formal EBP project begins with a trigger- an impetus to explore possible changes to practice. The start point can be either a knowledge focused trigger that that emerges from awareness of innovative research findings and thus follows a more traditional research utilization path, or a problem focused trigger that has its roots in a clinical or organizational problem and thus follows a path that more closely resembles ad EBP path. The model outlines a series of activities with three critical decision points. 1.Deciding whether the problem is a sufficient priority for the organization exploring the possible changes; if yes a team is formed to proceed with the project ; if no a new trigger will be sought. 2. Deciding whether there is a sufficient research base ; if yes , the innovation is piloted in the practice setting; if no , the team woul d either search for other sources of evidence or conduct its own research. 3. Deciding whether the change is appropriate for adoption in practice ; if yes a change would be instituted and monitored; if no the team would continue to evaluate quality of care and search for new knowledge.The 5 steps of EBN 1. SELECT A TOPIC OR PROBLEM The first step is to select a topic. Ideas come from different sources but are categorized in two areas: Problem-focused triggers and Knowledge focused triggers. When selecting a topic, nurses should formulate questions that are likely to gain support from people within the organization. An interdisciplinary medical team should work together to come up with an agreement about the topic selection. The priority of the topic should be considered as well as the severity of the problem.Nurses should consider whether the topic would apply to many or few clinical areas. Also, the availability of solid evidence should be considered because providing proof of the research will increase staffs' willingness to implement into nursing practice. Problem & Knowledge Focused Triggers Problem focused triggers are identified by health care staff through quality improvement, risk surveillance, benchmarking data, financial data, or recurrent clinical problems. Problem focused triggers could be clinical problems, or risk management issues.Knowledge focused triggers are created when health care staff read research, listen to research conferences or encounter EBP guidelines published by federal agencies or organizations. Knowledge based triggers could be new research findings that further enhance nursing, or new practice guidelines. It is important that individuals work closely together to reach the optimum outcome for the chosen topic. Some things that would ensure collaboration are working in groups to review performance improvement data, brainstorming about ideas, and achieving consensus about the final selection.With both types of triggers, it is impo rtant to ensure that there is a general consensus about the importance of the problem and the need for improving practice. The method of selecting a topic does not appear to have any bearing on the success of an EBP project. What is important however is that the nursing staff who will implement an innovation are involved in topic selection and that key stake holders are â€Å"on board. † 2 . FORM A TEAM TO ASSEMBLE AND EVALUATE EVIDENCE Some might become overwhelmed when they first learn about EBP and apply it for reasons other than improvement of patient care.Forming a team increases the chance of EBP being adopted. A team becomes paramount in implementation, and evaluation of the EBP. It is important to have representatives of the team from authority members of the organization and also grassroots members. It is also important to consider interdisciplinary involvement to decrease rejection, and for all to have an understanding of the project. All these individuals have a gr eat impact on the possibility of successful implementation.Other factors to put into consideration include power figures in the organization that may directly or indirectly sabotage the efforts if they are not consulted, and fully included in EBP implementation. The EBP team should have explanations that clearly define the types of patients, setting, outcomes, interventions and exposures. This should be in simplified language that is comprehensible to a lay person. The role of the practitioners is remarkable in any meaningful gains, they are therefore inevitable and their role becomes pivotal.The approach they adopt and their ability to educate the co-workers, answer their questions, and clarify any misconceptions greatly improves the outcomes. In doing a literature reviews background for a new study, a central goal is to discover where the gaps are and how best to advance knowledge. For EBP projects which typically have as end products, prescriptive practice protocols or guidelines , literature reviews are typically much more formalized. The emphasis is on amassing comprehensive information on the topic, weighing pieces of evidence and integrating information to draw conclusions about the state of knowledge.Commentators have noted that integrative reviews have become the cornerstone of EBP. If an integrative view already exists it is wise to make sure that it is as up-to-date as possible and that new findings published after the review are taken into account. Moreover, even a published integrative review needs to be critiqued and the validity of its conclusions assessed 3. ASSESSING THE IMPLEMENTATION POTENTIAL One of the most challenging issues in using EBP in the clinical setting is learning how to adequately frame a clinical question so that an appropriate literature review can be performed.When forming a clinical question the following should be included: the disorder or disease of the patient, the intervention or finding being reviewed, possibly a compari son intervention, and the outcome An acronym used to remember this is called the â€Å"PICO† model: P = who is the Patient Population? I = what is the potential Intervention or area of Interest? C = is there a Comparison intervention or Control group? O = what is the desired Outcome? Once the topic is selected, the research relevant to the topic must be reviewed, in addition to other relevant literature.It is important that clinical studies, (including meta-analyses, metasyntheses and meta-aggregation) and well-known and reliable existing EBP guidelines are accessed in the literature retrieval process. With the internet at one’s fingertips, a plethora of research is just a few clicks away. However, just because you found it in a respectable journal does not signify high quality research. When reviewing any article for evidence retrieval read it very closely. Articles can appear to be precise and factual on the surface but with further and much closer examination, flaws can be found.The article can be loaded with opinionated and/or biased statements that would clearly taint the findings, thus lowering the creditability and quality of the article. Use of rating systems to determine the quality of the research is crucial to the development of EBP. There are several rating systems available online. Time management is crucial to information retrieval. Nurses making their way through the vast amount of research available may find it helpful to read research articles or critical reviews instead of clinical journals.To maintain high standards for EBP implementation, education in research review is necessary to distinguish good research from poorly conducted research. Equally important is that the materials being reviewed, consider if they are current. To assess the implementation potential of an innovation in a particular setting several issues should be considered particularly the transferability of the innovation, the feasibility of implementing it, an d it’s cost benefit ratio Transferability :- The main issue with regard to transferability is that whether it makes good sense to implement an innovation in the new practice setting.If there is some aspect of the practice setting that is fundamentally incongruent with the innovation in terms of its philosophy, types of client served, personal, financial or administrative structure, then it might make little sense to try to adapt the innovation Feasibility :- Assessing the feasibility concerns address various practical concerns about the availability of staff resources, the organizational climate, the need for and availability of external resources and assistance and the potential for clinical evaluation.An important issue here is that whether the nurse will have control over the innovation. When the nurse do not have full control over the new procedure, it is important to recognize the interdependent nature of the project and to proceed as early as possible to establish the n ecessary co operative arrangements. Cost benefit ratio:- It is an important aspect of EBP project innovation. The cost benefit assessment should encompass likely cost and benefits to various groups including clients, staff and the overall organization.Clearly the most important factor is the client. A cost benefit assessment should consider the opposite side of the coin as well that is the cost and benefits of not instituting an innovation. Documentation of the implementation potential is an innovation is highly recommended. Committing ideas to writing is useful because it can resolve ambiguities, serve as a problem solving tool if there are barriers to implementation , and be used to persuade others of the value of the project. 4.APPLY THE EVIDENCE/IMPLEMENTING AND EVALUATING THE INNOVATION After determining the internal and external validity of the study, a decision is arrived at whether the information gathered does apply to your initial question. It’s important to address questions related to diagnosis, therapy, harm, and prognosis. The information gathered should be interpreted according to many criteria and should always be shared with other nurses and/or fellow researcher. Building on the Iowa model, this phase of project likely would involve the following activities Developing an evaluation planCollecting baseline data pertaining to those outcomes, to develop a counterfactual against which the outcomes of the innovation would be assessed. Developing a written EBP guideline based on the synthesis of evidence, preferably a guideline that is clear and user friendly, and that uses such devises as flow charts and decision trees. Training relevant staff in the use of the new guideline and if necessary marketing the innovation to users so that it is given in a fair test.Trying the guideline out on one or more unit or with a sample of clients Evaluating the pilot project in terms of both processes and outcomes. 5. DISSEMINATION OF THE RESULTS OF THE PRO JECT It is the final optional step but it is the one which is highly advisable. It is done so that the results of the project can be disseminated to other participating staff members. How to Critique a Research Article The critiquing process is the building block and foundation for the multiple steps that are to follow in the successful implementation of EBP.This is so because you must first ensure that the material and research that you are trying to convince others to accept is reliable and accurate. By taking the time to thoroughly critique a study you can point out both the strengths and weaknesses of the findings and weigh them accordingly. Successful completion of this vital step will help â€Å"weed out† the material lacking the needed proof of effectiveness, therefore minimizing useless, or even harmful, implementation of new practices in the healthcare field.Once the literature is located, it is helpful to classify the articles as either conceptual (theory and clinic al articles) or data-based (systematic research reviews). Before reading and critiquing the research, it is useful to read theoretical and clinical articles to have a broad view of the nature of the topic and related concepts, and to then review existing EBP guidelines Critiquing criteria are the standards, evaluation guides, or questions used to judge (critique) an article.In analyzing a research report, the reader must evaluate each step of the research process and ask questions about whether each step of the process meets the criteria. Remember when you are doing a critique, you are pointing out strengths, as well as the weaknesses. To critique an article you must have some knowledge on the subject matter. There is no replacement for reading the article many times. The reader must search the article for contradictions, illogical statements, and faulty reasoning.It is important to evaluate every section of the research article. Each section has different criteria to meet, in order to be considered a well-written addition to the article. What are the barriers to implementing evidence-based practice? The barriers that prevent nurses from using research in everyday practice have been cited in numerous studies, and some common findings have emerged Nurses often report the following: †¢ Lack of value for research in practice †¢ Difficulty in changing practice†¢ Lack of administrative support †¢ Lack of knowledgeable mentors †¢ Insufficient time to conduct research †¢ Lack of education about the research process †¢ Lack of awareness about research or evidence-based practice †¢ Research reports/articles not readily available †¢ Difficulty accessing research reports and articles †¢ No time on the job to read research †¢ Complexity of research reports†¢ Lack of knowledge about EBP and critique of articles †¢ Feeling overwhelmed by the processDespite these barriers, nurses are engaging in EBP and making a difference in patient outcomes. Furthermore, barriers can be overcome through organizational efforts focused on integrating research in practice and using strategies such as journal clubs, nursing grand rounds, and having research articles available for review The use of evidence based practice depends a great deal on the nursing student's proficiency at understanding and critiquing the research articles and the associated literature that will be presented to them in the clinical setting.According to, Blythe Royal, author of Promoting Research Utilization in nursing: The Role of the Individual, Organization, and Environment, a large amount of the preparation requirements of nursing students consists of creating care plans for patients, covering in depth processes of pathophysiology, and retaining the complex information of pharmacology. These are indeed very important for the future of patient care, but their knowledge must consist of more when they begin to practice.Evidence base d nursing in an attempt to facilitate the management of the growing literature and technology accessible to healthcare providers that can potentially improve patient care and their outcomes. Nancy Dickenson-Hazard states, â€Å"Nurses have the capacity to serve as caregivers and change agents in creating and implementing community and population-focused health systems. † There is also a need to overcome the barriers to encourage the use of research by new graduates in an attempt to ensure familiarity with the process.This will help nurses to feel more confident and be more willing to engage in evidence based nursing. A survey that was established by the Honour Society of Nursing and completed by registered nurses proved that 69% have only a low to moderate knowledge of EBP and half of those that responded did not feel sure of the steps in the process. Many responded, â€Å"Lack of time during their shift is the primary challenge to researching and applying EBP. † There is always and will always be a desire to improve the care of our patients.The ever increasing cost of healthcare and the need for more accuracy in the field proves a cycle in need of evidence based healthcare. The necessity to overcome the current issues is to gain knowledge from a variety of literature not just the basics. There is a definite need for nurses, and all practitioners, to have an open mind when dealing with the modern inventions of the future because these could potentially improve the health of patients. There are many barriers to promoting evidence based practice.The first of which would be the practitioner's ability to critically appraise research. This includes having a considerable amount of research evaluation skills, access to journals, and clinic/hospital support to spend time on EBN. Time, workload pressures, and competing priorities can impede research and development. The causes of these barriers include nurse's and other professional practitioners lack of knowledge of research methods, lack of support from professional colleagues and organizations, and lack of confidence and authority in the research arena.Another barrier is that the practice environment can be resistant to changing tried and true conventional methods of practice. This can be caused because of reluctance to believe results of research study over safe, traditional practices, cost of adopting new practices, or gaining momentum to rewrite existing protocols It is important to show nurses who may be resistant to changes in nursing practice the benefits that nurses, their patients, and their institutions can reap from the implementation of evidence-based nursing practice, which is to provide better nursing care.Values, resources and evidence are the three factors that influence decision-making with regard to health care. All registered nurses and health care professionals should be taught to read and critically interpret research and know where to find articles which rela te to their field of care. In addition, nurses need to be more aware of how to assess the information and determine its applicability to their practice. Another barrier to implementing EBN into practice is lack of continuing education programs.Practices do not have the means to provide workshops to teach new skills due to lack of funding, staff, and time; therefore, the research may be tossed dismissed. If this occurs, valuable treatments may never be utilized in patient care. Not only will the patients suffer but the staff will not have the opportunity to learn a new skill. Also, the practitioners may not be willing to implement change regardless of the benefits to patient care. Another barrier to introducing newly learned methods for improving treatments or patients' health is the fear of â€Å"stepping on one's toes†.New nurses might feel it is not their place to suggest or even tell a superior nurse that newer, more efficient methods and/or practices are available. The pe rceived threat to clinical freedom offered by evidence-based practice is neither logical nor surprising. Resistance to change and to authority is part of human nature. When we make decisions based upon good quality information we are inconsistent and biased. Human nature offers many challenges to evidence-based practice. Can we do a better job of promoting evidence-based practice?And even if we find and use the evidence, will we make consistent unbiased decisions? Even if clinicians do act consistently it is possible that their decisions are consistently biased. People put different values on gains and losses. CONCLUSION Nursing is truly an art and a science. EBP not only provides elements of each aspect, but also contributes to the profession’s overall development. As a result EBP improves everyday practice in by providing empirical data to guide the nursing interventions. Use of research in EBP provides opportunity for research utilisation by all in the field of profession.

Emperor Pedro II of Brazil

Virtual Teams Essays - 734 Words

1. As a manager of a virtual team, what team characteristics would you be especially concerned about so that the team’s work would be exceptional? As a manager of a virtual team I believe that it is extremely important to understand what key characteristics are needed in order for the team to flourish and excel. The ability to openly communicate, Understand cultural differences as well as overall knowledge of technology are some of the fundamentals I would be most concerned about. Communication is the major key to a prosperous team/group. If a team leader and/or group member has trouble with openly communicating with others, it will be impossible for team rules and regulations to be established. It is crucial for a virtual team to†¦show more content†¦Her teaching style always challenged thoughts and intrigued minds beyond the surface. Fuller gave a listening ear beyond â€Å"office hours† giving each individual her undivided attention. Before developing an opinion and or answer, Fuller made sure she fully understood the question or situation at hand. If unfamiliarity arose she didn’t hesitate to place th e conversation on hold to deliver an adequate and well thought through answer. While Professor Fuller was much older, more than half of the class devoted countless hours listening to her feedback and considered her a close friend. We all trusted what our beloved professor had to say mainly because we knew her answers would never be biased or judgmental. As an exceptional communicator I believe an individual must be able to connect, listen and deliver clear and concise answers when necessary. 3. Choose one topic in the two assigned chapters that appeal to you as something that is practical and can be applied in the workplace. Briefly explain it and describe how you would use it. Be sure to cite appropriate sources for support. Working currently in the field of customer service being an effective listener is necessary and naturally appeals to me. I believe that this form of communication is extremely practical and should always be the first communication method used. According to Gibson, Ivancevich, Donnelly, and Konopaske, 2012 â€Å"Managers must seekShow MoreRelatedCommunication in Virtual Team1524 Words   |  7 PagesCommunication in Virtual Team Capella University September 26, 2013 Communication Communication is the activity of conveying information though the exchange of thoughts, messages, or information by speech, visuals, signals, writings or behaviors (Grosse, 2002). These processes are done over time, culture, and geographic boundaries, while this has become a common practice for organizations and has give rise to the concept of globally dispersed teams known as virtual teams (LaLonde, 2011). Read MoreThe Characteristics Of A Virtual Team2033 Words   |  9 PagesA virtual group is a gathering of people who work crosswise over time, space and authoritative limits with connections reinforced by networks of correspondence innovation. Effectiveness of virtual team: The Characteristics of Effective Virtual Teams are as follows: Executive Support: Their study found that virtual groups do well when administrators bolster the improvement of social connections at work (consequently constructing trust among associates) and show coordinated effort. The routes in whichRead MoreAdvantages And Disadvantages Of Virtual Teams739 Words   |  3 PagesA virtual team is defined as a group of individuals who work across time, space and organizational boundaries with links strengthened by webs of communication technology. (https://managementhelp.org/groups/virtual/defined.pdf) Virtual Teams are also known as a Geographically Dispersed Team (GDT). 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Due to globalization, organizations have become cross functional, and utilizes modernRead MoreVirtual Team And Its Advantages And Disadvantages1302 Words   |  6 PagesVirtual Team and Its Advantages and Disadvantages During the last decade, organizations have been working more with technology making it their master. Technology is not only about new equipment; it is mostly about new ideas and techniques used. Virtual team is a new approach used today. Virtual groups or teams have been used from parent to keep contact with teacher to corporations to create new international business relationships. How far can virtual team be more efficient than face to face relationshipsRead MoreA Review On Virtual Team948 Words   |  4 PagesOF â€Å"VIRTUAL TEAM† AJAYI IBITOLA TOMISIN Griffith School of Engineering, Griffith University, Gold Coast, QLD4222, Australia This paper presents a review of virtual team. It defines the virtual team, present opportunities in virtual team, discusses its managerial and technological issues, lists the advantages disadvantages of virtual teams and recommends for the future. 1. Introduction 1.1. Overview of virtual team A virtual team whether across the street or across the world is a team whoseRead MorePros And Cons Of Virtual Teams1496 Words   |  6 PagesFinal Research Paper: The Pros and Cons of Virtual Teams A History in the Making From its very inception, the Internet was intended to create a means for a secure, reliable communication network, with the strategy to connect people with data. Information that once stood evanescent and restrictive by one’s personal radius of influence, flourished into an evergreen and ever-spanning wealth of information. Alan Evans, Kendall Martin, and Mary Anne Poatsy, co-authors of Technology in Action (2016) state:Read MoreThe Birth Of Virtual Teams2759 Words   |  12 PagesAbstract Teams have always contributed significantly towards the successful operation of any organization. Traditionally, team members had to endure the challenges of time, distance, and even cultural differences in order to successfully complete a team activity. However, recent advancements in technology have led to the birth of virtual teams. The paper aims to explore the effectiveness and differences ofvirtual teamsas compared to face-to-face teams. The evaluation will be on the basis of dimensions

Essay about Limitless Linchpins The Success and Failure...

American foreign policy is a virtual jumble of ideologies, among which stands the concept of isolationism, an avoidance of global relations. From 1913 to 1937, the United States struggled with the question of to be or not to be, and presidents ranged from complete global disengagement to war declarations. However, although they all wrestled with the idea isolationism, not all presidents acted equally. Woodrow Wilson’s domestic success and idealistic foreign failure is a testament to the inequality, whilst Franklin Delano Roosevelt, in contrast, gradually emerged from the theory of isolationism as a worldwide political butterfly. The two chiefs in the center, Warren G. Harding and Calvin Coolidge, presided over an isolated, stagnant period†¦show more content†¦He supported women’s suffrage and social programs, and he had excellent ideas for America’s future. In this way, Wilson was a success. However, his skill with his own nation is an underscore to his failure with the nations of the world. Initially, for example, Wilson objected to American entrance into WWI; he pushed the proposal away until it was unsafe to continue to do ignore it. Only when the American people felt legitimately threatened did he ask Congress to enter the war. To his credit, however, once Wilson committed to interventionism, he did not shy back. Wilson’s Fourteen Points, which aimed to create global unity with the new League of Nations, were his children. He refused to compromise on any of the disputed sections, despite threats from the legislature to fail the bill. Perhaps Wilson’s initial lethargy was due to some vision of his future, as the grand ideas that were so successful stateside failed to translate into the global arena. His idealism and intellectualism, seemingly advantageous traits, contributed to his ultimate legacy as an unsuccessful president. As a former university president, Wilson was an intellectual who studied political philosophy in order to form his grandiose opinions. While an intelligent and competent leader of the United States is necessary, he should also possess a connection to the people and a willingness to change. Wilson had neither of those qualities, as his isolationist policies

Non-Violence Free Essays

string(55) " by God to break the laws of man when they are unjust\." With the simultaneous proliferation of technology and global-poltical danger in the modern world, strategies for countering both political oppression, and the outbreak of political violence and war are urgently needed.   Although the century which has recently slipped away — the Twentieth Century — may be remembered as â€Å"the bloodiest in history† (Martin 625), with hundreds of millions of people killed in wars and with weapons of mass destruction being â€Å"invented, built, deployed and further refined† (Martin 625) during the same century when state-sponsored genocide and terrorism became commonly known quantities. Against this backdrop of chaos, war, and an increasingly dangerous technological landscape, the philosophy of non-violence, or passive resistance, gained   an historical currency which is still unmatched. We will write a custom essay sample on Non-Violence or any similar topic only for you Order Now The activities of important leaders like Gandhi, King, and Mandela revealed the truly earth-changing, paradigm shifting   potential of non-violence resistance as a method for seizing social initiative and political power. Because of the actions of these three important leaders. plus a host of other lesser-known figures, and the action of millions of ordinary activists, â€Å"it can be argued that the rise of nonviolent action was one of the most important developments of the century†Ã‚   (Martin 625), and one which has tremendous potential for application in today’s difficult and complex political world. While it is true enough that Gandhi, King, and Mandela over similar models of non-violent leadership and that key tenants of what might be termed a â€Å"universal† sense of non-violence pervade each leaders’ philosophies, distinct differences are also recognizable   when a comparison of the three leaders’ ideas, activities, and accomplishments is carried out. Such a study of similarities and differences in the philosophies and actions of these important leaders is crucial to understanding how the philosophy of non-violence may be applied in modern times as an antidote to the dangerous and oppressive climate that threatens much of the world. As noted, â€Å"Nonviolent action — including methods such as rallies, strikes, boycotts and sit-ins — has become increasingly important in the past century as a method for waging conflict and promoting social change† (Martin 625) and due to the urgent pressure caused by modern political and social chal lenges such as terrorism, global warming, the protection of human rights and religious freedom, adapting past approaches of non-violent action to present-day challenges may be beneficial. Non-violent activism may, in fact, help bring about important social changes: â€Å"Some areas for future expansion of the role of nonviolent action include replacing military defence, technological design, challenging capitalism, bureaucratic politics, information struggles and interpersonal behaviour† (Martin 625); the suggestion of non-violence as an all-pervading philosophy applicable throughout the full strata of political and social issues may sound grandiose, but as we will see, this idea is actually a core-concept for the three leaders in our study. In this regard, non-violent philosophy takes it roots not in social, political or philosophical idea, but in spiritual convictions or even, spiritual revelation. An abstraction of  Ã‚   â€Å"nonviolence principles, building on the core dynamic of political jiu-jitsu in contexts where the opponent does not use physical force† (Martin 625) may be the best way to intuitively understand that non-violence does not indicate non-action of total passivity in the face of aggression. Such a distinction is difficult to pin down, but it is a crucial part of activism, manifest in the breaking of â€Å"unjust† laws, and passive resistant behaviors which, if not violent, certainly imply action by the participants. In order to shed light on some of the more challenging aspects of non-violent activism, such as the spiritual aspect, as well as investigate the potential application of non-violent philosophy in modern times, the following brief examination of non-violent philosophy according to each leader: Gandhi, King, and Mandela, will attempt to sketch a general idea of the similarities and differences of each leader’s approach and attempt to discover if any type of universal vision of non-violent philosophy can be discovered. For Gandhi, non-violence arises out of an organic human impulse or † basic law of our being† (Gandhi, and Merton 23); such a conviction, foe Gandhi, is based not in genetic or biological assumptions or evidence or in logistical philosophical reasoning, but in spiritual ideas. For Gandhi, â€Å"Ahimsa (non-violence)†Ã‚   (Gandhi, and Merton 23) is the opposite of   â€Å"himsa (violence)†Ã‚   (Gandhi, and Merton 23), and the attributes of each energy are just as distinct. While Ahimsa â€Å"can be used as the most effective principle for social action, since it is in deep accord with the truth of man’s nature and corresponds to his innate desire for peace, justice, order, freedom, and personal dignity† (Gandhi, and Merton 23), its opposite energy, himsa, â€Å"degrades and corrupts man† (Gandhi, and Merton 23); therefore to bring himsa energy against himsa energy would be to fight fire with fire. By contrast, the application of ahimsa or non-violent energy to the problem of himsa energy â€Å"heals and restores man’s nature, while giving him a means to restore social order and justice† (Gandhi, and Merton 23). The important thing to remember here is that, for Gandhi, ahimsa and himsa energies are not metaphorical reflections or abstract concepts, they are living, spiritual realities.   Although the capacity for ahimsa resides in each person, modern society has left humanity with a much more desperate and disordered reliance on himsa energy. For Gandhi such an alienation of man’s true capacities has resulted in a culture where â€Å"violence seems to be the very foundation of social order and is â€Å"enthroned as if it were an eternal law,† so that man is called upon by society to reject love† (Gandhi, and Merton 43) and instead embrace a social reality which is enforced by violence or by the threat of violence. To meet this himsa-driven society with ahimsa energy adn non-violence requires supreme courage on behalf of the activist. This extraordinary courage, according to Gandhi, is derived from God: This courage demands nothing short of the ability to face death with complete fearlessness and to suffer without retaliation. Such a program is meaningless and impossible, Gandhi thinks, without belief in God. The implication in Gandhi’s ideas is that the activist or the â€Å"Satyagrahi† is enabled, in fact: bound, by God to break the laws of man when they are unjust. You read "Non-Violence" in category "Essay examples" The decision as to how it is determined that a law is unjust is murky and unclear, as we will see: this same ambiguity marks both King and Mandela’s own approach to non-violent activism. The historical truth is that Gandhi made clear that each â€Å"Satyagrahi was bound to resist all those laws which he considered to be unjust and which were not of a criminal character, in order to bend the Government to the will of the people† (Gandhi 21) and it is this kind of â€Å"twisting† which comprises the active aspect of non-violent activism. The expression of non-violent activism by King relied as much on spiritual conviction as that of Gandhi. This conviction brought about a similar adherence to   the concept of breaking â€Å"unjust† laws as a method of civil disobedience. King, like Gandhi, found justification for the breaking of social laws by the invocation of Divine Power. The result was that King experienced some difficulty in making his racial and social activism truly universal, although such a desire to do so formed an underlying precept of his overall strategy for social and political change. In a rather unique twist of philosophy, King opted to not only resist unjust laws non-violently, but tor each out to his so-called opponents: white racists with language of reconciliation, good-will, and fellowship. King’s invocations of â€Å"the good to be achieved† (Wolf, and Rosen) were powerful   counterparts to his criticisms of the social conditions he sought to transform. Since King’s goal was to â€Å"to bring the Negro into the mainstream of American life as quickly as possible† (Wolf, and Rosen) his reliance on civil disobedience and the breaking of unjust laws by Divine justification, like Gandhi’s, requires a deeper examination. Such revelation is possible due to King’s extensive writings; in particular his â€Å"Letter From a Birmingham Jail† a famous document where he addresses the concern of his fellow clergymen regarding the breaking of laws by civil activists. The letter repeatedly appeals to a shared sense of religion; King also cites Biblical examples to bolster his argument.  Ã‚   Responding to the criticism that his actions and the actions of his followers, even though non-violent in practice, ultimately resulted in violence on the behalf of the white Southerners who beat and jailed the protestor (and sometimes lynched or otherwise killed African Americans), King compared the fight for civil rights wi th the fight of Jesus to spread the gospel. King’s appeal via religion and spirituality was based in a desire for unity and understanding. While he denied accusations of extremity or of inciting violence, he admitted that the impulse for civil rights was, by his reckoning, the will   of God.   Ã‚   King advises that the will of all people is toward freedom and equality.   â€Å"Oppressed people cannot remain oppressed forever. The yearning for freedom eventually manifests itself, and that is what has happened to the American Negro.† (King) By forwarding the notion that civil rights are an inevitable outgrowth of both God’s will and the flow of history, King is, in effect, offering a justification for his tactics and philosophies regarding civil rights.The justification for the elements of passive resistance which had led to violent confrontation is also based in King’s ideas of justice. King’s idea is that God’s law is the highest law and that man’s laws may be broken when they obviously disagree with or even insult God’s law. With the belief that God’s Law is the highest law and that history shows that all people will struggle for freedom and liberty, and by appealing to the rational sense of justice and the emotional and spiritual senses of brotherhood and love, King attains justification for his actions but does not seek to evade or subvert laws outright. Unlike King, Mandela called for deliberate confrontation with the forces of apartheid which apposed his view of liberation and freedom. Although he repeatedly expressed his opinion that he was not, in fact, a racist himself, Mandela’s rhetoric unlike King and Gandhi’s, â€Å"was more polarizing† (Wolf, and Rosen); for example, Mandela never attempted â€Å"to appeal to whites† and he sought by confrontational rhetoric coupled with non-violent activism to † through greater polarization to galvanize the situation to crisis levels, thereby compelling action by the international community† (Wolf, and Rosen) which in itself presents a divergence in thought from Gandhi and King both of whom sough reconciliation with their enemies. However, rhetoric was simply another tool in Mandela’s non-violent philosophical approach. When, at key moments, he might have called for violence, in actuality, he strove for non-violent change. he might have â€Å"easily have called for a violent overthrow of the South African government upon his release after 27 years in prison† (Pierce 1) but rather than do so, he advocated non-violent resistance. The idea of appealing to the world community adds another dimension to the non-violent approach of activism. For Mandela, â€Å"In this scenario, â€Å"the international community† becomes subrogated to the role of â€Å"broader constituency† that Mandela evoked indirectly†Ã‚   (Wolf, and Rosen) but whose support and intervention proved crucial to his success. Because of his sometimes volatile rhetoric, Mandela took special care to â€Å"emphasize his desire for reconciliation across the divide of colour† and repeatedly â€Å"pledged himself an ew to work for a multiracial society in which all would have a secure place† (Pierce 175). Contemporary Impact of Non-Violent Strategies Despite the contributions of great thinkers and activists like those examined in the preceding, brief discussion, the fact is contemporary society seems no less preoccupied with violence than ever before. By examining the media one has the distinct impression that in the world of media and media-related technology, a great deal of concern has been expressed by both everyday observers and specialists in social-psychology over the possible negative impacts that media, and in particular media portrayals of violence, may have upon small children and adolescent children. One of the most complex facets of the issue is the still-unknown impact that new technologies such as 24 hour a day cable programming, widespread Internet access, and the â€Å"digital age† in general will have on the generation of young people who are presently the first to be so overwhelmed by such widespread media and media technologies. An immersive and nearly all-pervading sense of media exists in modern homes that, in fact, the presence of media can be said to form a basis of â€Å"reality† for many people. It is this exact kind of blurred distinction between perceived reality (based on media models and information) and reality (those aspects of life which stand apart from media and media-based models).   The distinction between media-reality and reality is not always clear, particularly to small children and adolescent children: â€Å"The boundaries between reality and unreality are especially permeable for small children. They are unable, through at least the age of three or four, to distinguish fact from fantasy. Even older children rarely manage to keep â€Å"real life† and vicarious experience in watertight compartments† (Bok 1999, 38) as we will see in the following discussion. The main impact repeated viewings of media violence seems to exert over small children and adolescents is the conflation of media-violence with organic psychological processes, many of which exist at such a deep, primitive psychological level in humans that manipulation of these emotions, and psychological dispositions remains, for the most part, beyond the conscious perception of the viewer. In conclusion, although the idea of media-responsibility regarding the impact of violent programming on children and young adults is often cited by critics as a form of censorship, ample scientific evidence and research exists to establish media-violence as a certain source of negative influence on young people. The fact of the matter remains despite the right of free speech that media-reality and actual reality are non-distinct at some deep, organic level in human psychology: † weeks earlier the Los Angeles police officers whose roadside beating of motorist Rodney King had been shown on TV screens the world over had been acquitted by an all-white jury[†¦]In that crisis, the boundaries between movies and reality blurred, not only for the public but also for Hollywood producers, directors, and actors who were seeing smoke rising beneath their hillside residences and hearing sirens echo up and down the canyons,† (Bok 1999, 36); with such a confusing and agitating impact of adult professionals, what can we expect when we expose our children to the same cultural ambiguities through media? If non-violent philosophy according to Gandhi, king, and Mandela is correct then violence is not   a norm in human society, but a constructed evil. If, as the proponents of non-violent philosophy suggest, â€Å"non-violent settlement of conflict is the human norm as we well know from daily experience. We are not programmed in some genetic way to violence† (Kent) than a radical re-visioning of our self-identity and self-image as human beings must take place not only in our media and in our educational facilities, but in our individual psyches as well. The applications of non-violent strategies in contemporary culture can be thought of as being as unknown as the implications of deep-space travel because even though the contributions of such historical leaders as Gandhi, King, and Mandela reveals the tremendous power of non-violent activism, the full impact of the philosophy as articulated by these men has far-reaching cultural, global-poltical, and spiritual implications which surpass anything which has yet occurred in history.   In other words, the â€Å"pioneers† of the â€Å"modern† incarnation of non-violent strategy which we have examined: Gandhi, King, and Mandela represent not the totality of what the non-violent philosophy can or wants to attain, but the mere beginning of a global transformation which is rooted not inly in the basic moral nature of humanity, but in humanity’s spiritual destiny and responsibility. Certainly individual leaders and activists continue to utilize the non-violent approach to attain important results in their areas of influence. Modern technology can also help individual activists to promote change by spreading honest information regarding the repercussions of violence and the militarization of political issues. One recent example is when â€Å"a 1991 massacre in the East Timorese capital Dill was recorded on videotape and subsequently broadcast worldwide, this generated enormous support for the resistance† (Martin 625); such applications of technology by individuals represent one small but important aspect of the many avenues of potential non-violent methods of change. Other methods include educational strategies based in the ideas forwarded by Gandhi, King, and Mandela. The recognition of the historical impact of the immensely influential strategies of non-violent change and civil disobedience will also help to inform and empower individuals who, in turn, may adopt some of the strategies and ideas reflected upon in the above discussion to help bring about social and political change through non-violent means. Conclusion The examination of three important world-leaders who based their activism in non-violent philosophy reveals certain universal traits among the different incarnations of non-violent activism. Among these universal traits is a belief in the breaking of â€Å"unjust† laws for the purpose of bringing about social and political change. This belief is often, if not always, accompanied by an ambiguous but firmly articulated that such a braking of laws is based in Divine Will. Another core belief seems to be that non-violence rather than violence is, in fact, more in keeping with humanity’s organic nature. This idea often results in a corresponding belief that the violence evident in human society is the result of a kind of perversion of humanity’s natural attributes into an unnatural and unhealthy state. Against this backdrop, it is very difficult if not impossible to envision the philosophies of non-violent activism as we know them today as anything short of a religious and spiritual philosophy with extremely pragmatic roots in social and political activism. Not only is the spiritual aspect of non-violent philosophy seemingly universal in the three historical figures studied in this short discussion, but the attributes of spirituality embraced by non-violent activists are, in themselves, of great and abiding interest to any observer. A discussion of this aspect alone would probably reveal that the philosophy of non-violence has existed as a spiritual conviction at various times in various cultures throughout the entire history of humanity. Works Cited Barker, Martin and Julian Petley, eds. 2001. Ill Effects: The Media/Violence Debate. New York:   Ã‚  Ã‚  Ã‚  Ã‚   Routledge. Bok, Sissela. 1999. Mayhem Violence as Public Entertainment. Reading, MA: Perseus Books. Gandhi, M. K. Non-Violent Resistance (Satyagraha). New York: Schocken Books, 1961. Gandhi, Mahatma, and Thomas Merton. Gandhi on Non-Violence. New York: New Directions   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Pub, 1965. Kent, Bruce. â€Å"Non-Violence: The History of a Dangerous Idea.† History Today Feb. 2007: 62+. Mandela, Tambo, and the African National Congress The Struggle against Apartheid, 1948-   1990. Ed. Sheridan Johns and R. Hunt Davis. New York: Oxford University Press, 1991. Martin, Brian. â€Å"Nonviolent Futures.† Futures 33.7 (2001): 625. Pierce, Victoria. â€Å"A Tribute to Dr. King Civil Rights Leader’s Legacy of Non- Violence Is Alive   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   around the World.† Daily Herald (Arlington Heights, IL) 29 Sept. 2006: 1. Wolf, Charles, and Brian Rosen. â€Å"Public Diplomacy: Lessons from King and Mandela.† Policy   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Review (2005): 63+. How to cite Non-Violence, Essay examples Non-Violence Free Essays With the simultaneous proliferation of technology and global-poltical danger in the modern world, strategies for countering both political oppression, and the outbreak of political violence and war are urgently needed.   Although the century which has recently slipped away — the Twentieth Century — may be remembered as â€Å"the bloodiest in history† (Martin 625), with hundreds of millions of people killed in wars and with weapons of mass destruction being â€Å"invented, built, deployed and further refined† (Martin 625) during the same century when state-sponsored genocide and terrorism became commonly known quantities. Against this backdrop of chaos, war, and an increasingly dangerous technological landscape, the philosophy of non-violence, or passive resistance, gained   an historical currency which is still unmatched. We will write a custom essay sample on Non-Violence or any similar topic only for you Order Now The activities of important leaders like Gandhi, King, and Mandela revealed the truly earth-changing, paradigm shifting   potential of non-violence resistance as a method for seizing social initiative and political power. Because of the actions of these three important leaders. plus a host of other lesser-known figures, and the action of millions of ordinary activists, â€Å"it can be argued that the rise of nonviolent action was one of the most important developments of the century†Ã‚   (Martin 625), and one which has tremendous potential for application in today’s difficult and complex political world. While it is true enough that Gandhi, King, and Mandela over similar models of non-violent leadership and that key tenants of what might be termed a â€Å"universal† sense of non-violence pervade each leaders’ philosophies, distinct differences are also recognizable   when a comparison of the three leaders’ ideas, activities, and accomplishments is carried out. Such a study of similarities and differences in the philosophies and actions of these important leaders is crucial to understanding how the philosophy of non-violence may be applied in modern times as an antidote to the dangerous and oppressive climate that threatens much of the world. As noted, â€Å"Nonviolent action — including methods such as rallies, strikes, boycotts and sit-ins — has become increasingly important in the past century as a method for waging conflict and promoting social change† (Martin 625) and due to the urgent pressure caused by modern political and social challenges such as terrorism, global warming, the protection of human rights and religious freedom, adapting past approaches of non-violent action to present-day challenges may be beneficial. Non-violent activism may, in fact, help bring about important social changes: â€Å"Some areas for future expansion of the role of nonviolent action include replacing military defence, technological design, challenging capitalism, bureaucratic politics, information struggles and interpersonal behaviour† (Martin 625); the suggestion of non-violence as an all-pervading philosophy applicable throughout the full strata of political and social issues may sound grandiose, but as we will see, this idea is actually a core-concept for the three leaders in our study. In this regard, non-violent philosophy takes it roots not in social, political or philosophical idea, but in spiritual convictions or even, spiritual revelation. An abstraction of  Ã‚   â€Å"nonviolence principles, building on the core dynamic of political jiu-jitsu in contexts where the opponent does not use physical force† (Martin 625) may be the best way to intuitively understand that non-violence does not indicate non-action of total passivity in the face of aggression. Such a distinction is difficult to pin down, but it is a crucial part of activism, manifest in the breaking of â€Å"unjust† laws, and passive resistant behaviors which, if not violent, certainly imply action by the participants. In order to shed light on some of the more challenging aspects of non-violent activism, such as the spiritual aspect, as well as investigate the potential application of non-violent philosophy in modern times, the following brief examination of non-violent philosophy according to each leader: Gandhi, King, and Mandela, will attempt to sketch a general idea of the similarities and differences of each leader’s approach and attempt to discover if any type of universal vision of non-violent philosophy can be discovered. GANDHI For Gandhi, non-violence arises out of an organic human impulse or † basic law of our being† (Gandhi, and Merton 23); such a conviction, foe Gandhi, is based not in genetic or biological assumptions or evidence or in logistical philosophical reasoning, but in spiritual ideas. For Gandhi, â€Å"Ahimsa (non-violence)†Ã‚   (Gandhi, and Merton 23) is the opposite of   â€Å"himsa (violence)†Ã‚   (Gandhi, and Merton 23), and the attributes of each energy are just as distinct. While Ahimsa â€Å"can be used as the most effective principle for social action, since it is in deep accord with the truth of man’s nature and corresponds to his innate desire for peace, justice, order, freedom, and personal dignity† (Gandhi, and Merton 23), its opposite energy, himsa, â€Å"degrades and corrupts man† (Gandhi, and Merton 23); therefore to bring himsa energy against himsa energy would be to fight fire with fire. By contrast, the application of ahimsa or non-violent energy to the problem of himsa energy â€Å"heals and restores man’s nature, while giving him a means to restore social order and justice† (Gandhi, and Merton 23). The important thing to remember here is that, for Gandhi, ahimsa and himsa energies are not metaphorical reflections or abstract concepts, they are living, spiritual realities.   Although the capacity for ahimsa resides in each person, modern society has left humanity with a much more desperate and disordered reliance on himsa energy. For Gandhi such an alienation of man’s true capacities has resulted in a culture where â€Å"violence seems to be the very foundation of social order and is â€Å"enthroned as if it were an eternal law,† so that man is called upon by society to reject love† (Gandhi, and Merton 43) and instead embrace a social reality which is enforced by violence or by the threat of violence. To meet this himsa-driven society with ahimsa energy adn non-violence requires supreme courage on behalf of the activist. This extraordinary courage, according to Gandhi, is derived from God: This courage demands nothing short of the ability to face death with complete   Ã‚   fearlessness and to suffer without retaliation. Such a program is meaningless and   Ã‚  Ã‚  Ã‚  Ã‚   impossible, Gandhi thinks, without belief in God.  (Gandhi, and Merton 43) The implication in Gandhi’s ideas is that the activist or the â€Å"Satyagrahi† is enabled, in fact: bound, by God to break the laws of man when they are unjust. The decision as to how it is determined that a law is unjust is murky and unclear, as we will see: this same ambiguity marks both King and Mandela’s own approach to non-violent activism. The historical truth is that Gandhi made clear that each â€Å"Satyagrahi was bound to resist all those laws which he considered to be unjust and which were not of a criminal character, in order to bend the Government to the will of the people† (Gandhi 21) and it is this kind of â€Å"twisting† which comprises the active aspect of non-violent activism. KING The expression of non-violent activism by King relied as much on spiritual conviction as that of Gandhi. This conviction brought about a similar adherence to   the concept of breaking â€Å"unjust† laws as a method of civil disobedience. King, like Gandhi, found justification for the breaking of social laws by the invocation of Divine Power. The result was that King experienced some difficulty in making his racial and social activism truly universal, although such a desire to do so formed an underlying precept of his overall strategy for social and political change. In a rather unique twist of philosophy, King opted to not only resist unjust laws non-violently, but tor each out to his so-called opponents: white racists with language of reconciliation, good-will, and fellowship. King’s invocations of â€Å"the good to be achieved† (Wolf, and Rosen) were powerful   counterparts to his criticisms of the social conditions he sought to transform. Since King’s goal was to â€Å"to bring the Negro into the mainstream of American life as quickly as possible† (Wolf, and Rosen) his reliance on civil disobedience and the breaking of unjust laws by Divine justification, like Gandhi’s, requires a deeper examination. Such revelation is possible due to King’s extensive writings; in particular his â€Å"Letter From a Birmingham Jail† a famous document where he addresses the concern of his fellow clergymen regarding the breaking of laws by civil activists. The letter repeatedly appeals to a shared sense of religion; King also cites Biblical examples to bolster his argument.  Ã‚   Responding to the criticism that his actions and the actions of his followers, even though non-violent in practice, ultimately resulted in violence on the behalf of the white Southerners who beat and jailed the protestor (and sometimes lynched or otherwise killed African Americans), King compared the fight for civil rights with the fight of Jesus to spread the gospel. King’s appeal via religion and spirituality was based in a desire for unity and understanding. While he denied accusations of extremity or of inciting violence, he admitted that the impulse for civil rights was, by his reckoning, the will   of God.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   King advises that the will of all people is toward freedom and equality.   â€Å"Oppressed people cannot remain oppressed forever. The yearning for freedom eventually manifests itself, and that is what has happened to the American Negro.† (King) By forwarding the notion that civil rights are an inevitable outgrowth of both God’s will and the flow of history, King is, in effect, offering a justification for his tactics and philosophies regarding civil rights.The justification for the elements of passive resistance which had led to violent confrontation is also based in King’s ideas of justice. King’s idea is that God’s law is the highest law and that man’s laws may be broken when they obviously disagree with or even insult God’s law. With the belief that God’s Law is the highest law and that history shows that all people will struggle for freedom and liberty, and by appealing to the rational sense of justice and the emotional and spiritual senses of brotherhood and love, King attains justification for his actions but does not seek to evade or subvert laws outright. MANDELA Unlike King, Mandela called for deliberate confrontation with the forces of apartheid which apposed his view of liberation and freedom. Although he repeatedly expressed his opinion that he was not, in fact, a racist himself, Mandela’s rhetoric unlike King and Gandhi’s, â€Å"was more polarizing† (Wolf, and Rosen); for example, Mandela never attempted â€Å"to appeal to whites† and he sought by confrontational rhetoric coupled with non-violent activism to † through greater polarization to galvanize the situation to crisis levels, thereby compelling action by the international community† (Wolf, and Rosen) which in itself presents a divergence in thought from Gandhi and King both of whom sough reconciliation with their enemies. However, rhetoric was simply another tool in Mandela’s non-violent philosophical approach. When, at key moments, he might have called for violence, in actuality, he strove for non-violent change. he might have â€Å"easily have called for a violent overthrow of the South African government upon his release after 27 years in prison† (Pierce 1) but rather than do so, he advocated non-violent resistance. The idea of appealing to the world community adds another dimension to the non-violent approach of activism. For Mandela, â€Å"In this scenario, â€Å"the international community† becomes subrogated to the role of â€Å"broader constituency† that Mandela evoked indirectly†Ã‚   (Wolf, and Rosen) but whose support and intervention proved crucial to his success. Because of his sometimes volatile rhetoric, Mandela took special care to â€Å"emphasize his desire for reconciliation across the divide of colour† and repeatedly â€Å"pledged himself anew to work for a multiracial society in which all would have a secure place† (Pierce 175). Contemporary Impact of Non-Violent Strategies Despite the contributions of great thinkers and activists like those examined in the preceding, brief discussion, the fact is contemporary society seems no less preoccupied with violence than ever before. By examining the media one has the distinct impression that in the world of media and media-related technology, a great deal of concern has been expressed by both everyday observers and specialists in social-psychology over the possible negative impacts that media, and in particular media portrayals of violence, may have upon small children and adolescent children. One of the most complex facets of the issue is the still-unknown impact that new technologies such as 24 hour a day cable programming, widespread Internet access, and the â€Å"digital age† in general will have on the generation of young people who are presently the first to be so overwhelmed by such widespread media and media technologies. An immersive and nearly all-pervading sense of media exists in modern homes that, in fact, the presence of media can be said to form a basis of â€Å"reality† for many people. It is this exact kind of blurred distinction between perceived reality (based on media models and information) and reality (those aspects of life which stand apart from media and media-based models). The distinction between media-reality and reality is not always clear, particularly to small children and adolescent children: â€Å"The boundaries between reality and unreality are especially permeable for small children. They are unable, through at least the age of three or four, to distinguish fact from fantasy. Even older children rarely manage to keep â€Å"real life† and vicarious experience in watertight compartments† (Bok 1999, 38) as we will see in the following discussion. The main impact repeated viewings of media violence seems to exert over small children and adolescents is the conflation of media-violence with organic psychological processes, many of which exist at such a deep, primitive psychological level in humans that manipulation of these emotions, and psychological dispositions remains, for the most part, beyond the conscious perception of the viewer. In conclusion, although the idea of media-responsibility regarding the impact of violent programming on children and young adults is often cited by critics as a form of censorship, ample scientific evidence and research exists to establish media-violence as a certain source of negative influence on young people. The fact of the matter remains despite the right of free speech that media-reality and actual reality are non-distinct at some deep, organic level in human psychology: † weeks earlier the Los Angeles police officers whose roadside beating of motorist Rodney King had been shown on TV screens the world over had been acquitted by an all-white jury[†¦]In that crisis, the boundaries between movies and reality blurred, not only for the public but also for Hollywood producers, directors, and actors who were seeing smoke rising beneath their hillside residences and hearing sirens echo up and down the canyons,† (Bok 1999, 36); with such a confusing and agitating impact of adult professionals, what can we expect when we expose our children to the same cultural ambiguities through media? If non-violent philosophy according to Gandhi, king, and Mandela is correct then violence is not   a norm in human society, but a constructed evil. If, as the proponents of non-violent philosophy suggest, â€Å"non-violent settlement of conflict is the human norm as we well know from daily experience. We are not programmed in some genetic way to violence† (Kent) than a radical re-visioning of our self-identity and self-image as human beings must take place not only in our media and in our educational facilities, but in our individual psyches as well. The applications of non-violent strategies in contemporary culture can be thought of as being as unknown as the implications of deep-space travel because even though the contributions of such historical leaders as Gandhi, King, and Mandela reveals the tremendous power of non-violent activism, the full impact of the philosophy as articulated by these men has far-reaching cultural, global-poltical, and spiritual implications which surpass anything which has yet occurred in history. In other words, the â€Å"pioneers† of the â€Å"modern† incarnation of non-violent strategy which we have examined: Gandhi, King, and Mandela represent not the totality of what the non-violent philosophy can or wants to attain, but the mere beginning of a global transformation which is rooted not inly in the basic moral nature of humanity, but in humanity’s spiritual destiny and responsibility. Certainly individual leaders and activists continue to utilize the non-violent approach to attain important results in their areas of influence. Modern technology can also help individual activists to promote change by spreading honest information regarding the repercussions of violence and the militarization of political issues. One recent example is when â€Å"a 1991 massacre in the East Timorese capital Dill was recorded on videotape and subsequently broadcast worldwide, this generated enormous support for the resistance† (Martin 625); such applications of technology by individuals represent one small but important aspect of the many avenues of potential non-violent methods of change. Other methods include educational strategies based in the ideas forwarded by Gandhi, King, and Mandela. The recognition of the historical impact of the immensely influential strategies of non-violent change and civil disobedience will also help to inform and empower individuals who, in turn, may adopt some of the strategies and ideas reflected upon in the above discussion to help bring about social and political change through non-violent means. Conclusion The examination of three important world-leaders who based their activism in non-violent philosophy reveals certain universal traits among the different incarnations of non-violent activism. Among these universal traits is a belief in the breaking of â€Å"unjust† laws for the purpose of bringing about social and political change. This belief is often, if not always, accompanied by an ambiguous but firmly articulated that such a braking of laws is based in Divine Will. Another core belief seems to be that non-violence rather than violence is, in fact, more in keeping with humanity’s organic nature. This idea often results in a corresponding belief that the violence evident in human society is the result of a kind of perversion of humanity’s natural attributes into an unnatural and unhealthy state. Against this backdrop, it is very difficult if not impossible to envision the philosophies of non-violent activism as we know them today as anything short of a religious and spiritual philosophy with extremely pragmatic roots in social and political activism. Not only is the spiritual aspect of non-violent philosophy seemingly universal in the three historical figures studied in this short discussion, but the attributes of spirituality embraced by non-violent activists are, in themselves, of great and abiding interest to any observer. A discussion of this aspect alone would probably reveal that the philosophy of non-violence has existed as a spiritual conviction at various times in various cultures throughout the entire history of humanity. Works Cited Barker, Martin and Julian Petley, eds. 2001. Ill Effects: The Media/Violence Debate. New York:   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Routledge. Bok, Sissela. 1999. Mayhem Violence as Public Entertainment. Reading, MA: Perseus Books. Gandhi, M. K. Non-Violent Resistance (Satyagraha). New York: Schocken Books, 1961. Gandhi, Mahatma, and Thomas Merton. Gandhi on Non-Violence. New York: New Directions   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Pub, 1965. Kent, Bruce. â€Å"Non-Violence: The History of a Dangerous Idea.† History Today Feb. 2007: 62+. Mandela, Tambo, and the African National Congress The Struggle against Apartheid, 1948-  Ã‚  Ã‚  Ã‚  Ã‚   1990. Ed. Sheridan Johns and R. Hunt Davis. New York: Oxford University Press, 1991. Martin, Brian. â€Å"Nonviolent Futures.† Futures 33.7 (2001): 625. Pierce, Victoria. â€Å"A Tribute to Dr. King Civil Rights Leader’s Legacy of Non- Violence Is Alive   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   around the World.† Daily Herald (Arlington Heights, IL) 29 Sept. 2006: 1. Wolf, Charles, and Brian Rosen. â€Å"Public Diplomacy: Lessons from King and Mandela.† Policy Review (2005): 63+. How to cite Non-Violence, Essay examples

The Water Babies by Charles Kingsley free essay sample

An in-depth examination of Kingsleys novel and his views concerning the treatment of children and his desire for social reform. In this paper the author examines the story of, ?The Water Babies?, by the English author, Kingsley and makes note of social conditions that existed in England at the time. The author examines some of the chapters closely and looks at Kingsley?s views on cleanliness and morals. The author makes note of the satirical comedy throughout and of Kingsley?s concerns about the treatment of children, and his desire for social reform. From the paper: The novel, charmingly and vividly told, is a work of art that was brought about by Kingsley?s concerns about the treatment of children, and his desire for social reform. Kingsley, a parson in the Church of England, a novelist, a Christian Socialist, a Protestant controversialist, poet, and an amateur naturalist managed to work every one of his life?s fondest beliefs and endeavors into Water Babies. We will write a custom essay sample on The Water Babies by Charles Kingsley or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page