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Fatigue is the feeling of tiredness or exhaustion of the body due to the explosion of a person to long hours of working witho

Subject

Students Name

Institution of Affiliation

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Fatigue is the feeling of tiredness or exhaustion of the body due to the explosion of a person to long hours of working without rest. Nurse fatigue, on the other hand, can be described as the feeling of mentally, emotionally as well as physical exhaustion or weariness that is caused by the high demands of nursing, leaving the nurses to have less time in rest and refreshes, overburdening them with work and more work making them completely weary. According to studies, the causes of fatigue in nurses have been attributed to the lack of enough sleep or the low quality sleep due to the work demands as well as other personal responsibilities among the nurses (Scott, Arslanian-Engoren & Engoren, 2014). Studies have cited that the long working hours, inadequate recovery time between the shifts, rotating shifts, night shifts, and excessive workload are among the contributing factors to fatigue among the nurses. Also, staff shortages, job demands as well as dangerous working environments as well the major contributing factors of fatigue among nurses.

Population

The population of the United States has grown to a significant number of millions over the last few years. The number of people in a country necessitates an increase in the number of nurses registered to take care of the health of the rising population. According to the data obtained in the year 2014, the United States had 874 registered nurses per 100,000 people, but the registered nurses are not distributed evenly throughout the nation. Hospitals in the states with low concentrations of the registered nurses may have difficulties in filling the empty nurse’s position, and this contributes to the high rates of nurses vacancies in the hospitals all year round. With such a reduced number of the registered nurses, the workforce that is required to take care of the population is significantly low, and this contributes to the long working hours with lesser shifts contributing to the eventual fatigue among the nurses. It is due to the prolonged exposure to the jobs that make the nurses deliver poor services with some of the time increasing the rate of mortality among the hospitalized patients, not because of negligence but due to fatigue.

Intervention

Exposing the nurses to the prolonged hours of working, poor working environment, as well as reduced time during shifts, have the ultimate effects of increasing the mental as well as the physical fatigue among the nurses (Steege & Rainbow, 2017). Each worker needs to rest so that they are able to give out their best during service delivery. The reduced number of the staff in the nurses’ department especially the registered nurses imply that those that are hired and are already in the working environment are pushed to the extremes, with a large percentage being expected to cover longer hours than it is expected of them. The reason as to why the registered nurses are required to work on extra- time is because if they are allowed to work on the normal routine, there will be some incidences of nurses being completely absent from the hospitals due to their reduced numbers.

Increasing the number of registered nurses in the nation, by making sure that each state has a recommendable of nurses such that the ration of n(10,000) is reduced will help in reducing the cases of fatigue among the nurses in the United States. High staffing implies that the nurses will now work with no strains as the number of people in the population that they are expected to serve will be reduced. Furthermore, a high number of registered nurses imply that less working hours will be achieved and thus more shifts will be granted to the nurses, and therefore, the impact of fatigue will be very much reduced to close to zero as the nurses are not pushed to extremes.

Comparison

The need for comparison between hiring more nurses to work in the health care facilities that are increasing the staffing and working with the current population of the registered nurses will help in distinguishing as to whether the cause of fatigue is due to understaffing (Steege & Rainbow, 2017). For a better comparison, it would be possible if the hiring of more nurses is done in phases and at different times in the states. With the variations in the number of staff at work, it will be straightforward to identify which group of nurses were subjected or are at a higher risk of being mentally or physically fatigued. Therefore, it will be possible to measure the performance as well as the impact that result from the variations in the number of nurses across the nation.

Outcome

Through changing the current working environment, it might be possible to reduce the levels of fatigue as well as the ultimately reduce the rates of medical errors. Improving the working environment implies increasing the number of staff working as registered nurses in the health facilities. With a large number of registered nurses, there will be reduced number of shifts, and therefore the available nurses are able to relax coming to job during the next shift being fresh minded with little or no traces of fatigue. Besides, the reduced number of shifts provides ample time for the nurses to solve their personal issues back at home and therefore helps them clear their mind before returning to work. Therefore they are devoted to providing the best services without coercion and with no pressure and therefore deliver quality services to the patients leading reduced mortality rates that are related to nurses’ fatigue.

Time

To be able to evaluate the outcome of performance and the overall patient satisfaction, it is advisable that a period of 4 to 6 months be allowed so that the effects and impacts can be felt. The period of between 4-6 months will enable a significant number of patients to have noticed the difference in the quality of services being provided. At the same time, the nurses will as well be able to note a change in their service delivery and it will be possible to identify whether the nurses’ fatigue is still present in the regions as to which the number of nurses has been increased. The impact of the intervention will be able to be identified within that duration of 4 to 6 months.

References

Fatigue in nurses. Retrieved from: Http://ojin.nursingworld.org/mainmenucategories/anamarketplace/anaperiodicals/ojin/tableofcontents/vol-16-2011/no1-Jan-2011/compassion-fatigue-a-nurses-primer.htmlScott, L. D., Arslanian-Engoren, C., & Engoren, M. C. (2014). Association of sleep and fatigue with decision regret among critical care nurses. American Journal of Critical Care, 23(1), 13-23.

Steege, L. M., & Rainbow, J. G. (2017). Fatigue in hospital nurses—‘Supernurse’culture is a barrier to addressing problems: A qualitative interview study. International journal of nursing studies, 67, 20-28.

Final Revision of Proposals

Final Revision of Proposals

Name:

Institution:

Course:

Tutor:

Date:

Who issues the request for Final Proposal Revisions? (FAR 15.307(b))

The request for Final Proposal revision is issued by the responsible Government urgencies after the proposals have been received, evaluated according to cost, technicalities associated with it among other factors. The request for Final Proposal Revision is issued by the government argents responses for receiving and evaluation the proposals.

What is a final proposal revision? (FAR 15.307(b))

Final Proposal Revision is the revamping of the original proposal. They are employed in negotiated acquirements to illustrate Government needs to the respective offerors and to importune proposals. The FPR is confirmed as a consequence of variations in the proposals as a retort to the “ask for” for Final Proposal Revision. This gives the authority concerned with the choosing with a enough information and reasons post FPR’s receipt.

3. When is a final proposal revision requested? (FAR 15.307(b))

The revision is requested after the initial proposal has been received and necessary discussions by the government officials conducted. After the negotiations, the agency gives chances of invitation of the chosen people/organizations who were offering the proposal so that they may present their finally revised proposals. This was in the past refereed to as Best and final Offers and abbreviated as BAFO. All the revisions are done as per the discussions that the offeror made with the government urgency during negotiations. The revision is done post the preparation and evaluation of the proposals of the offeror as complemented by feedbacks to the necessity for FPR. The proposal must have been accepted and selected among the present proposals.

4. To whom is the Final Proposal Revision request sent? (FAR 15.307(b))

Normally, any final Proposal revision is sent to the government argents. The proposal is obtained under FAR Negotiable Procurement. After this, the responsible personnel (urgency) curries out negotiations (discussions) with the person who is offering the proposal and this is done post the receipt. This receipt that is issued at this stage mainly entails the cost of the proposal and any technical issues as per the proposal. The final Proposal Revision request is sent to the person/people who are offering the proposal but sent by the government urgency.

5. Can you request a Final Proposal Revision from only one of the offerors in the competitive range? (FAR 15.307(b))

This is possible. All depends on the issues and the price of that proposal. In cases where the prices of other proposals are higher and there are numerous technicalities that are associated with that given proposal, it is rejected and revision not requested. This in some cases happen to majority of the proposals and in some cases only one is left.

6. How is a final proposal revision requested? Why? (FAR 15.307(b)

After the proposals have been made, they are reviewed and evaluated. The best is chosen from them and negotiations with the government urgencies commence immediately. Sometimes, the solicitation may authorize the organization offering the proposal to revamp and change its conditions and terms.

7. Can you request a Final Proposal Revision from offerors at different times as you complete discussions with each? Why or Why not?

This is not possible. This is due to the reasons that before the revisions re requested, the best has to be chosen. The policy cannot allow this as well. All other factors have to be considered and all aspects reviewed before any revision sis requested. By requisition for revision indicates that that given proposal has been accepted. Two or more proposal cannot be accepted at the same time and this eliminates the possibility of having two or more proposals under revision. Suppose the proposal f one organization is removed from the range of those are competing, there should be no further revision to be requested from that offeror.

8. What factors should be considered in setting a reasonable common cutoff date and time for final proposal revisions?

In setting a god cutoff date that the proposals should be handed-in, there are numerous factors to be considered. Suppose the project was to start urgently, the time for submission must be enough to provide for revision if necessary. Time is one of the factors. The other is for flexibility and comfort. This is because suppose the chosen proposal fails, the next best alternative can be selected. This is the reason for collecting the proposed proposals early. The factor that depends the time tat the proposal should be collected is time of announcements. Adequate time should be given tat all the public have opportunity of reviewing it and submitting their proposals. This is to eliminate the biasness and the chances tat the other proposal providers do not have adequate time and chance for application. All the possible organization and individuals will have good and equal chances.

9. Does a Final Proposal revision request have to specifically allow a hand-carried response?

No. all the responses are to be posted and obtained from there. And in ay case the applications were online, the same method or even posting have to be done. This leaves no room for hand-carried responses. The other reason for posting is for confirmation and future references. All the public offices recommend that all the responses be posted.

10. Can you address more than one Final Proposal Revision, if necessary?

There is no chance of doping that. At the time the urgency give out the invitations, the routine clearly indicates that all negotiations have been finalized and it further illustrates that no other discussions will be conducted. The revision is done once and for all after which invitation is issued. Final Proposal Revision is the final and the last chance for those who offer the proposal and the government. In short, the Final Revised Proposal is the final opportunity that the government and the offeror have to give the appealing proposal. This is the policy that governs the submission and the revision of the proposals. It is straightforward and applicable in all government proposals.

Reference:

Alele, P. (2006). Proposal. Procedures by Government. 2nd edition., 3rd volume. Macmillan Publishers, pg 34-35.

U.S. Government Agency

P.O. Box 3008

Washington, DC 20405

June 24, 199X

Acquisition Directorate (AD-211)

Purdon-Cecom Corporation

ATTN: Ms. Lois Brenner

P. O. Box 619490

DFW Airport, TX 75206-9490

SUBJ: Purdon-Cecom Proposal #9X-555

Dear Ms. Brenner:

This letter is to confirm our telephone request of June 1 for a “best and final” offer from your firm. You are hereby offered the opportunity to submit a price revision to your proposal. No further technical information or revision is desired.

Your response must arrive at this office not later than 10:00 AM, local daylight saving time, on June 27, 199X.

Be advised that any final proposal revision received after the specified time and date will be subject to the FAR provision, 52.215-1, Instructions to Offerors – Competitive Acquisition, which is contained in the RFP.

Please indicate any restrictions to be placed on information contained in your proposal under the provisions of the “Freedom of Information Act.” In addition, ensure your proposal includes any appropriate restrictive legends.

Sincerely,

Pat U. Back

Contracting Officer

Identify Linkage Between the Economic Concepts With the Discussion in the Article

Demand & Supply

Q 1. Identify Linkage Between the Economic Concepts (Demand& Supply, Price Elasticity of Demand, Market Equilibrium) With the Discussion in the Article.

The linkage between supply and demand triggers the forces that motivate resource allocation. In regard to the article, in a perfect market, pricing increases on commodity products and services would translate into a shift in quantity demanded. This is illustrated in figure 1 below. The law of demand stipulates that, when all factors are held constant, high prices of a commodity result in the decreasing demand for the commodity. Hence, pricing increases on commodities would translate into a shift in quantity demanded of the commodity (Arthur, 2004). Figure 1 below illustrates that the demand curve slopes downwards.

(Arthur, 2004).

Figure 1.Every point on the demand curve depicts a direct link between price (P) and quantity demanded (Q). Therefore, at point A, the price is P1, while the quantity demanded is Q1. The demand relationship curve exemplifies the negative correlation between quantity demanded and price demanded. On the other hand, contrasting to the law of demand, supply relationship depicts an upward inclined slope. This depicts that the higher the price of a commodity, the higher the quantity would be supplied (Daniel, 2009). This is illustrated in figure 2 below.

(Arthur, 2004).

Figure 2

Every point on the curve depicts a direct linkage between Price (P) and quantity supplied (Q). At point B, the price will be P2, while the quantity supplied will be Q2.

In the event that demand and supply are equal, the demand function and supply function would intersect. At this point, the economy would be at equilibrium, and the allocation of goods is most efficient. This scenario is depicted in figure 3 below.

(Arthur, 2004).

Figure 3.

Equilibrium takes place at the meeting point of the supply and demand curves. The quantity at this point will be Q*, while the price of the commodities will be P*. These figures in this case are known as equilibrium quantity and price. In the short term, market equilibrium is attained when the quantity supplied is equal to quantity demanded. In such an event, the market clears. This is because the market does not have additional quantity demanded or quantity supplied, at the market clearing price.

However, that specific market price may not result to equilibrium in the long term. In the short term, producers may lack adequate time to completely adjust to existing market conditions. Some existing producers may lack profits or they would be unable to cover all their operational costs at the existing market price. Producers in such a situation would consider exiting the industry, or refrain from further allocation of capital to the industry. If producers are generating profits, then more resources would be allocated to the industry. In the long term, the entire factors of production can be varied.Long-run equilibrium is anticipated in the market to over time. However, the process would take considerably a long duration. In reality this may never materialize since supply and demand curves are continuously shifting. Figure 4 below illustrates what would happen in the event of an increase in demand

Figure 4. Effects of a Shift in Demand

D0 is the initial demand curve, and D1 is the resultant new demand curve. The resultant market equilibrium price owing to a shift in the demand curve will rise from P0 to P1, tentatively in the short-run.  The quantity demanded and supplied will as well increase from Q0 to Q1.Eventually, in a market economy, there are two forces that will be experienced in the market:

Suppliers would have incentives to supply extra quantities of the commodity, and extra resources would be allocated for the production of this commodity. This interplay will tend to raise the quantity supplied and reduce the market prices.

Consumers would have incentives to explore for substitutes, thus lessening their purchase of the initial commodity. This interplay will tend to reduce the quantity demanded as well as the market price.

Oligopoly

However, the market economy in the case scenario is not a perfect market. The kind of market in the case scenario is referred to as an oligopoly. In an oligopoly, few firms comprise an industry. This group of firms controls the price and place high entry barriers. The oligopolistic firms offer commodities that are usually almost similar and, therefore, the firms, which compete for the market share, are co-dependent as a consequence of market forces (Weber, 2011). This is the case in the Singapore’s taxi market. The demand curve in the Singapore’s taxi market would be a kinked demand curve.

The kinked demand curve presupposes that a business such as ComfortDelgro may experience a dual demand curve for its services based on the expected response of other transport firms in the transport industry to an adjustment in its taxi fares. The general postulation of the theory is that businesses in an oligopoly are seeking to maintain and protect their market share and that competitors are less prone to contest another’s price increase but may contest a price reduction. This means that competitors in an oligopoly respond asymmetrically to adjustments in prices of a rival firm. This theory is illustrated in figure 4 below.

(Morgan, 2007).

Figure 5

In figure 5 the kinked demand curve, is composed of two sections BD’ and DB. The demand curve is bent at point B. The kink is produced at the existing market price level BM. The section of the demand curve above the current price level is highly elastic and the section of the demand curve under the current price level is comparatively inelastic (Morgan, 2007). Therefore in the event that an oligopolistic increases its fares from $10 per trip to $12 per trip, the firm would lose a large share of the market and its sales would decrease from 120 units to 40 units. This depicts a loss of 80 units in sales as most of its customers would engage the services of other transport providers from the competing firms who may be charging their services at $10 per trip. Therefore an increase in fares above the current level illustrates that the demand curve to the left of and over point B is comparatively elastic (Weber, 2011).

The taxi companies in the oligopolistic market have no inducement to increase or decrease their fares. They may prefer to charge at the current fare level as a result of the reaction function. The kinked-demand theory in oligopoly exemplifies the high level of interdependence in the firms that comprise an oligopoly. In this case, the market demand curve in each company in the oligopoly is established by the price decisions and output of the rival companies in the oligopoly.

However, the kinked-demand theory is regarded as an incomplete hypothesis of oligopoly for a number of reasons. The theory does not clarify how the oligopolistic find the kinked point in the market demand curve. Secondly, the kinked-demand hypothesis does not allocate for the prospect that price increases by one company in the oligopoly are matched by other companies in the oligopoly. In conclusion, the kinked-demand hypothesis does not reflect on the prospect that companies in the oligopoly conspire in setting price and output. The prospect of collusive behavior is illustrated in the substitute theory referred to as the cartel theory of oligopoly (Weber, 2011).

References

Arthur, W. (2004). Complexity & the Economy. Science 84 (2), 107–109.

Daniel, H. (2009). The S Corporation Financial Adjustment. Handbook of Business Appraisal & Intellectual Property Evaluation. New York, McGraw Hill.

Morgan, A. (2007). Econometric Ideas. Cambridge: Cambridge U.P.

Weber, H. (2011). Budgeting Process. Contemporary Strategic Investments. Montvale: Columbia Press.