Importance of Customer Satisfaction

Importance of Customer Satisfaction Customer Service Introduction According to Hansemark and Albinsson(2004), satisfaction is an overall customer attitude towards a service provider, or an emotional reaction to the difference between what customers anticipate and what they receive, regarding the fulfilment of some need, goal or desire. Customer loyalty, on the other hand, according to Anderson and Jacobsen (2000) is actually the result of an organisation creating a benefit for a customer so that they will maintain or increase their purchases from the organisation. True customer loyalty is created when the customer becomes an advocate for the organisation, without incentive. To be successful, organizations must cater to the needs, wants and demands of their customers. That is the reason why many companies have continuously focused on the importance of customer satisfaction and loyalty. Moreover, it has a positive effect on an organisations profitability. There is also a close and positive connection between customer satisfaction and loyalty. Therefore, customer satisfaction and loyalty are all very important for an organization to be successful. Many researchers have looked into the importance of customer satisfaction. Kotler(2000) defined satisfaction as: a persons feelings (pleasure or disappointment) resulting from comparing a product performance in relation to his or her expectations. Hoyer and MacInnis (2001) said that satisfaction can be associated with feelings of acceptance, happiness, relief, excitement, and delight. There are many factors that affect customer satisfaction. According to Hokanson (2001), these factors include: friendly employees, courteous employees, knowledgeable employees, helpful employees, accuracy of billing, billing timeliness, competitive pricing, service quality, good value, billing clarity and quick service. In order to achieve customer satisfaction, organisations must be able to fulfil their customers needs and wants (La Barbera and Mazursky, 2000). Customers needs state the felt deprivation of a customer (Kotler, 2000).Whereas customers wants, according to Kotler (2000) refer to the form taken by human needs as they are shaped by culture and Individual personality. However, Bowen and Chen (2001) said that having satisfied customers is not enough, there has to be extremely satisfied customers. This is because customer satisfaction leads to customer loyalty. Bansal and Gupta (2001):Building customer loyalty is not a choice any longer with businesses: its the only way of building sustainable competitive advantage. Building loyalty with key customers has become a core marketing objective shared by key players in all industries catering to business customers. The strategic imperatives for Building a loyal customer base is as: Focus on key customers Proactively generate high level of Customer satisfaction with every Interaction Anticipate customer needs and respond to them before the competition does Build closer ties with customers Create a value perception Sivadas and Baker-Prewitt (2000) said there is an increasing recognition that the ultimate objective of customer satisfaction measurement should be customer loyalty. Fornell (2002) said high customer satisfaction will result in increased loyalty for the firm and that customers will be less prone to overtures from competition. This view was also shared by Anton (2002) who said that satisfaction is positively associated with repurchase intentions, likelihood of recommending a product or service, loyalty and profitability. Loyal customers would purchase from the firm over an extended period of time. (Evans and Berman, 2003). Guiltinan, Paul and Madden (2001) said that satisfied customers are more likely to be repeat (and even become loyal) customers. Sivadas and Baker-Prewitt (2000) Satisfaction also influences the likelihood of recommending a departmental store as well as repurchase but has no direct impact on loyalty. Thus satisfaction in itself will not translate into loyalty. However, satisfaction will foster loyalty to the extent that it is a prerequisite for maintaining a favourable relative attitude and for recommending and repurchasing from the Store. Once customers recommend a department store it shows loyalty towards that store. Thus the key to generating loyalty is to get customers to recommend a store to others. Also, customers are likely to recommend a department store when they are satisfied with that store and when they have a favourable relative attitude towards that store. Evans and Berman (2003): Companies with satisfied customers have a good opportunity to convert them into loyal customers who purchases from those firms over an extended period. Conclusion Based on the views and research, it can be concluded that customer satisfaction is very important. Thus, though customer satisfaction does not guarantee repurchase on the part of the customers but still it plays a very important part in ensuring customer loyalty. This point has been echoed by Gerpott et al. (2001) when they said customer satisfaction is a direct determining factor in customer loyalty, which, in turn, is a central determinant of customer retention. Therefore, according to me, organisations should always strive to ensure that their customers are very satisfied. References Anderson, H. Jacobsen P. N., 2000, Creating Loyalty: Its Strategic Importance in Your Customer Strategy. Bansal, S. Gupta, G., 2001, Building Customer Loyalty Business-to-Business Commerce. Bowen, J. T. Chen, S. L., May 2001, the Relationship between Customer Loyalty and Customer Satisfaction, International Journal of Contemporary Hospitality. Evans, J. R. Lindsay, W. M., 2003, the Management and Control of Quality. 3rd Ed. Guiltinan, J. P., Paul, G. W. Madden, T. J.,2001, Marketing Management: Strategies and Programs Hansemark, O. C. Albinson, M., 2004, Customer Satisfaction and Retention: The Experiences of Individual Employees, Managing Service Quality. Hoyer, W. D. MacInnis, D. J., 2001, Consumer Behaviour. 2nd Ed. Hokanson, S., January 2, 2001, The Deeper You Analyse, The More You Satisfy Customers Kotler, P., 2000, Marketing Management. 10th Ed. LaBarbera, P. A. Mazursky, D., 2000, A Longitudinal Assessment of Consumer Satisfaction. Sivadass, E. Baker-Prewitt, J. L., 2000, An Examination of the Relationship Between Service Quality, Customer Satisfaction, and Store Loyalty.

Anorexia and Bulimia - A Growing Epidemic Essay -- Causes of Bulimia N

Bulimia and anorexia is a growing epidemic in America. Bulimia and Anorexia can start at any age, but is most common between the ages of 11-17 years old. Of all the individuals that experience this illness only 50% of all of them are ever cured, and another 6% that suffer from this horrible illness will experience death. This illness has become very deadly to our young adults. Bulimia and anorexia can cause a distorted image in a persons mind because they truly believe they are overweight. In their minds they are beyond doubt obese. Even if the person weighs only 95 pounds. This sickness has the person thinking they are overweight. This could bring about a severe bout of depression. Once the person hits the stage of depression professional help is needs because the feeling of being overweight and depression could put the individual over the edge. Individual experiencing Bulimia go on what is called eating binges. Eating binges are when people eat longer amounts of food in less then two hours. (Internet3) Then after they binge they feel guilt or shame so they need to undo their behavior. To undo their behavior they make themselves vomit, or they take laxatives, water pills or starve themselves. (Cauwel21) Binge and poring usually occurs more than two times a week for at least three months. (Internet1) What cause bulimia and anorexia? It can be brought on by stress or depression, but most often dieting causes it. (Erichsen 12) Stressful situations such as death can bring about bulimia and anorexia. Also many young adults frequently experience sessions of depression for various circumstances during their adolescent’s years. But, again most of the time bulimia and anorexia is trigger by dieting. (Moe 21) Many psychological factors play a big role in the cause of bulimia and anorexia. People that have a fear of growing up sometimes have incidents with anorexia because they think that if they stop eating they want get older or bigger. (Erichsen15) Ford5 People need to take control of themselves if they are anorexia or bulimia because they can control how much they eat or if they want to eat. (internet1) If a person feels out of control because of difficulties at home they should control what they eat or if they are going to eat. The people that suppress anger need to release it and get it out. If there is a major life change, such as divorce, family problems,... ...rging behavior. Challenging the weight and body image beliefs of the patients is also part of the treatment. Improving self-esteem and ability to communicate needs and feelings may be the key to the treatment. Each case is different, so the course of treatment for each patient is different but the guideline for case is the same. Anorexia patients mostly start off with small amounts of nutritious and easily digestible foods such as eggs, custards, soups, and milkshakes are usually what they eat the first days. People that have anorexia extra calcium and multivitamins pills to help with the large loss the body has sustained. (internet2) Bulimia and anorexia causes a distorted image in a persons mind, this is because they believe they are overweight. Depression is usually one of the first symptoms. Many people have suffered from this illness or still are suffering. Bulimia and anorexia could happen to a person at any age, but is most common in teenagers because of the problems young adults experience during. Most of the time it is trigger by dieting, but no matter how it is triggered it is a very dangerous illness. Do you Yahoo!? Yahoo! Small Business - Try our new resources site!

A Visit to the Bristol Caverns in Tennessee :: Tourism

A Visit to the Bristol Caverns in Tennessee The Bristol Caverns are over 200,000,000 years old and were used as a secret way of travel for the Cherokee Indians (http://www.tenntrips.com). Being located in Bristol, Tennessee, the caverns are a part of the Appalachian Mountain Region. The Bristol Caverns are underground and considered a historical monument. During your visit to the caverns you can learn about history, while getting your exercise, at an affordable price. The Bristol Caverns are open all year around, except for on holidays, and the time that you are able to visit is subject to change during different seasons. You can visit the Bristol Caverns from 9a.m.-5p.m. on Monday through Saturday and from 12:30p.m.-5p.m. on Sundays. It is suggested that you call before attempting to go to the Bristol Caverns because of the number of tourists. (http://www.bristolcaverns.com). The drive from the ETSU campus to the caverns takes about forty-two minutes. In order to get to the Bristol Caverns you can start on 11E, get off at the Bluff City exit, take it to 394, turn right onto 435, and you will then see the Bristol Caverns on the left. Upon arrival you will be expected to pay an admission fee of $9.00, which can change, according to age. The Bristol Caverns offers special rates and tours for groups interested in touring. One of these group opportunities, "Wild Tours" (http://www.bristolcaverns.com), gives groups the chance to explore parts of the ca ve normally not seen, provided a guide is present. The entire tour requires a lot of walking, so wearing tennis shoes is recommended. Dress prepared for a cool environment because while inside the cave you will experience temperatures from 50-60 degrees. As you walk along the tour of the Bristol Caverns, a tour guide will inform you about the history of the cave: such as the original entrance place to the caverns used by the Cherokee Indians and how an early pioneer would store his fruit in the cave for extended freshness (tour guide). While the guide leads you through the cave of the caverns, you can view many formations and scenes. The formations are called stalagmites and stalagtites, which are created by the moisture and minerals in the cave hardening. One inch of these formations lengths can take from 150-300 years to form (tour guide). During the tour you will venture through different levels of the cave.

The Health Benefits of Exercise :: Physical Exercise Fitness Health

The first group of people to utilize the benefits of exercise were the Greeks. It was Aristotle a famous philosopher of the time who brought this concept to the people at the time. The word exercise means "Bodily exertion for the sake of developing and maintaining physical fitness." In today’s world you find people from all walks of life, age and sex exercising in some form or another. Whether it be running in a park or lifting weights in a gym, let’s face its here to stay. There are basically three types of exercise. First we have aerobic meaning with oxygen, this type uses oxygenated blood produced by the heart and lungs to supply the body with energy. This type is long in duration, an example of an exercise would be jogging. Next we have anaerobic meaning without oxygen it uses the stored energy in the muscles only and is short in duration an example would be the 200m hurdles. Finally we come to crosstraining. It encompasses both aerobic and anaerobic styles to make maximum use of all systems this would be accomplished by starting and stopping at different intervals. For example you could go running down a path then stop do push-ups then repeat the cycle again and again. Some of the benefits that can be achieved through exercise are lower blood pressure and an increase in stroke volume. Blood pressure (the force that the blood exerts on the vessel wall). Stroke volume ( the amount of blood that passes through the heart in one beat).By doing this the heart will become more efficient and will be able to recover faster after exercise is over. Remember the heart is a muscle the harder you work it the stronger it becomes. By working the muscles of the body they will naturally become stronger. They will be able to do more work for longer periods of time without fatigue or injury occurring. You will have a greater sense of mental awareness (a clear head). You will feel more attentive about what is gong on around you, as well as feeling less stress from daily problems which brings us back again to less stain on the heart. The benefits to be had by the aging population are unbelievable. People who stay active (exercise) through their life live longer than those who are sedentary (don’t exercise) "Most of the decline we associate with aging is really the result of inactivity.

London Ambulance Service Failure

The London Ambulance fiasco ? The London Ambulance Service (LAS) Computer Aided Despatch (CAD) system failed dramatically on October 26th 1992 shortly after it was introduced: †¢ †¢ †¢ The system could not cope with the load placed on it by normal use; The response to emergency calls was several hours; Ambulance communications failed and ambulances were lost from the system. ? A series of errors were made in the procurement, design, implementation, and introduction of the system.  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 1 London Ambulance Service ? ? Managed by South West Thames Regional Health Authority. Largest ambulance service in the world (LAS inquiry report) †¢ †¢ †¢ †¢ Covers geographical area of over 600 square miles Resident population of 6. 8 million people (greater during daytime, especially central London); Carries over 5,000 patients every day; 2,000-2,500 calls received daily, of which 1,3001,600 are emergency calls.  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 2 Computer-aided despatch systems ? Provide one or more of the following: †¢ †¢ †¢ Call taking; Resource identification; Resource mobilisation; Ambulance resource management. CAD software & hardware; Gazetteer and mapping software; Communications interface (RIFS). Radio system; Mobile data terminals (MDTs); Automatic vehicle location system (AVLS). ? Consist of: †¢ †¢ †¢ †¢ †¢ †¢  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 3 T he manual system to be replaced ? Call taking †¢ Recorded on form; location identified in map book; forms sent to central collection point on conveyor belt; Form collected; passed onto resource allocator depending on region; duplicates identified. Resource allocator decides on which resource to be mobilised; recorded on form and passed to dispatcher; Dispatcher telephones relevant ambulance station, or passes mobilisation instructions to radio operator if ambulance already on road; ? Resource identification †¢ ? Resource mobilisation †¢ ? Whole process meant to take < 3 minutes. Software Engineering Case Studies Slide 4  ©Ian Sommerville 2004 Concept/design of the CAD system ? Existing systems dismissed as inadequate and impossible to modify to meet LAS’s needs †¢ Intended functionality â€Å"greater than available from any existing system†. To consist of Computer Aided Dispatch; Computer map display; Automatic Vehicle Location System (AVLS); Must integrate with existing MDTs and RIFS (Radio Interface System). Near 100% accuracy and reliability of technology; Absolute cooperation from all parties including CAC staff and ambulance crews. ? Desired system: †¢ †¢ ? Success dependent upon: †¢ †¢  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 5 Problems: Procurement (i) ? Contract had to be put out to open tender †¢ Regulations emphasis is on best price; 35 companies expressed interest in providing all or part of the system †¢ Most raised concerns over the proposed timetable of less than 1 year until full implementation. ? Previous Arthur Andersen report largely ignored †¢ †¢ Recommended budget of ? 1. 5M and 19 month timetable for packaged solution. Both estimates to be significantly increased if packaged solution not available; Report never shown to new Director of S upport Services. ? Only 1 out of 17 proposals met all of the project team’s requirements, including budget of ? 1. 5M. Software Engineering Case Studies Slide 6 Ian Sommerville 2004 Problems: Procurement (ii) ? Successful consortium †¢ †¢ †¢ Apricot, Systems Options (SO), Datatrak; bid at ? 937k was ? 700k cheaper than the nearest bid; SO’s quote for the CAD development was only ? 35k †¢ Their previous development experience for the emergency services was only for administrative systems. Ambiguity over lead contractor. Systems manager: Career ambulance man, not an IT professional, already told that he was to make way for a properly qualified systems manager; Analyst: Contractor with 5 years experience working with LAS. ? 2 key members of evaluation team: †¢ †¢  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 7 Problems: Project management ? Lead contractor responsible †¢ †¢ Meant to be SO, but they quickly became snowed under, so LAS became more responsible by default; No relevant experience at LAS or SO. ? ? Concerns raised at project meeting not followed-up. SO regularly late in delivering software †¢ Often also of suspect quality, with software changes put through ‘on the fly’. ? ? Formal, independent QA did not exist at any stage throughout the CAD system development. Meanwhile, various technical components of the system are failing regularly, and deadlines missed. Software Engineering Case Studies Slide 8  ©Ian Sommerville 2004 Problems: Human resources & training (i) ? ? ? ? ? Generally positive attitude to the introduction of new technology. Ambiguity over consultation of ambulance crews for development of original requirements. Circumstantial evidence of resistance by crews to Datatrak equipment, and deliberate misleading of the system. Large gap between when crews and CAC staff were trained and implementation of the system. Inability of the CAC and ambulance staff to appreciate each others’ role †¢ Exacerbated by separate training sessions. Software Engineering Case Studies Slide 9  ©Ian Sommerville 2004 Problems: Human resources & training (ii) ? ? ? ? ? ? ? Poor industrial relations. Management ‘fear of failure’. CAD system seen as solution to management’s desire to reduce ‘outdated’ working practices. System allocated nearest resource, regardless of originating station. System removed flexibility in resource allocation. Lack of voice contact exacerbated â€Å"them and us†. Technical problems reduced confidence in the system for ambulance crews and CAC staff.  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 10 System problems Need for near perfect information †¢ Without accurate knowledge of vehicle locations and status, the system could not allocate optimum resources. There were numerous possible reasons for incorrect information being passed back to the system. Numerous technical problems with the system, including: †¢ Failure to identify all duplic ated calls; †¢ Lack of prioritisation of exception messages; †¢ Exception messages and awaiting attention queues scroll off top of screen. ? Poor interface between crews, MDTs & the system †¢ ? Unreliability, slowness and operator interface †¢  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 11 Configuration changes ? Implementation of the system on 26 October involved a number of significant changes to CAC operation, in particular: †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ Re-configuring the control room; Installing more CAD terminals and RIFS screens; No paper backup system; Physically separating resource allocators from radio operators and exception rectifiers; Going ‘pan London’ rather than operating in 3 divisions; Using only the system proposed resource allocations; Allowing some call takers to allocate resources; Separate allocators for different call sources. Ian Sommerville 2004 Software Engineering Case Studies Slide 12 So, what happened? ? ? Changes to CAC operation made it extremely difficult for staff to intervene and correct the system. As a consequence, the system rapidly knew the correct location and status of fewer and fewer vehicles, leading to: †¢ †¢ †¢ †¢ Po or, duplicated and delayed allocations; A build up of exception messages and the awaiting attention list; A slow up of the system as the messages and lists built up; An increased number of call backs and hence delays in telephone answering.  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 13 Why did it fail? ? Technically, the system did not fail on October 26th †¢ †¢ Response times did become unacceptable, but overall the system did what it had been designed to do! Failed 3 weeks later due to a program error – this was a memory leak where allocated memory was not completely released. Management; Union; System manager; Government. ? It depends who you ask! †¢ †¢ †¢ †¢  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 14 Lessons learned ? Inquiry report makes detailed recommendations for future development of the LAS CAD system, including: †¢ †¢ †¢ †¢ †¢ †¢ Focus on repairing reputation of CAD within the service; Increasing sense of ‘ownership’ for all stakeholders; They still believe that a technological solution is required; Development process must allow fully for consultation, quality assurance, testing, training; Management and staff must have total, demonstrable, confidence in the reliability of the system; Any new system should be introduced in a stepwise approach.  ©Ian Sommerville 2004 Software Engineering Case Studies Slide 15

Professional nursing boundaries Essay

Nurses known as a caregiver and provide close relationship not only between patient and the hospital but also for other healthcare profession such as doctors and assistant medical officer and also between communities. Their services are very important and therefore they performing â€Å"heart† in the medical and healthcare service provision in Malaysia. Due to the rapidly changing in Malaysia healthcare environment, the nurses are required to provide care through their extended roles and provide services rendered by other healthcare professional in order to complement the health service to the population. Therefore, Malaysian nurses have become aware for legal and ethical issues that have impacted on their practise and recognised the importance of practice that have legal and ethical principle thus promoting competency and decision making. In Malaysia itself, most of the major population still choose to get treatment from government. It is because government hospital provides good quality service in healthcare, provide an advances technologies, provide skilled staff, sophisticated equipment beside the cheapest service that they get. In the healthcare service nowadays, professional boundaries are important issues and have been a quite popular topic. Basically, if we search an internet pertaining to professional boundaries we always often get the result are mainly about interactions between nurses and patient or client. According to College of Registered Nurse of British Columbia (no date), urged that within the nurse and client relationship, the client relationship are often vulnerable because the nurse has influenced, access to information, and specialized knowledge and skill. If the nurse does not use her judgement carefully they tend to misused their power. 2(wrds count 263) Like other health care service, nurses can cause harm to patient if they do not full fill their needs. To provide a safest care to patient, nurses must know the concepts of professional boundaries. This boundary also defined as a professional relationship are sharing or gave other profession or nurse their work based on cooperation and team work among them. ‘Professional boundaries in nursing are defined as limits which protect the space between  the professional’s power and the client’s vulnerability’ stated by (Nursing & Midwifery Board of Australia, 2010 p1). However, also quoted by Nursing and Midwifery Council (no date, p1) ‘that boundaries in nursing also define as the limits of behaviour which allow a nurse or midwife to have a professional relationship with a person in their care’. Within this assignment I intend to explore the problem encountered in both relationship and professional boundaries between the perioperative nurse and the general anaesthesia nurse (GA nurse). This assignments objective are also to gain knowledge and experience between the Ga nurse and perioperative nurse. I am a trained staff nurse currently work as a general anaesthetic nurse for almost 10 years in the tertiary hospital situated in Kota Kinabalu. I have my post basic in advance diploma of anaesthesia after I finish my 1 year course in anaesthesia field. I noticed that there is a boundary in my workplace between the perioperative nurse and the general anaesthesia nurses, the boundaries are mainly traditional boundaries. But even though the work task is different but the main purpose is for patient safety and quality of work. Basically perioperative nurse are working in the operating theatre.Their roles are to assist surgeon in various surgical procedure, and also helping patient comfortable before surgery. Scope of perioperative work also widening by helping patient after and post operatively. This nurse helps the smoothness of the surgical procedure. A scrub nurse and circulating nurse is specially trained nurse who work with surgeon in the operating room. Most of our scrub nurse and circulating nurse are very experienced, skilful nurses and most of them already had their advance diploma in perioperative nursing. In my workplace I identified a traditional blurred boundaries pertaining to my practice area. The blurred boundaries are identified in some operating room setting between the circulating nurse and general anaesthesia nurse. In my workplace the general anaesthesia nurse will be allocate in each of operating room setting. The general anaesthesia nurse will assists the anaesthesia doctor during the induction of anaesthesia, giving medication, setting intravenous line, anchoring endotracheal tube also to keep patient calm and safe before the induction of anaesthesia. Normally, the GA nurse  tends to have an advance training in anaesthesia such as certificate in anaesthesia where we will get after 1 year attend post basic in anaesthesia. In Malaysia, we had to have the certificate before we can work in the operating theatre as a GA nurse. As quoted by Lukosius et al (2004, p523), ‘to be a good nurse in practice, the organization must have legislation and protected titles for clinical nurse specialist, nurse midwives, and nurse anaesthetist, so they can work according to their standard practice’. Working in the operating room is about team work among the various types of healthcare such as nurses, assistant medical officer, surgeon, anaesthetic doctor and also hospital attendance. Each of them plays their roles in the operating theatre by providing service direct and indirectly. This team work among the health care services are the strength of all organizations but the boundaries within this working area a still been taking care and are respected. Blurred boundaries that I identified happen in my workplace are due to some problem such as shortage of staff and because of an ineffective inter-professional working. The Ga nurse and the perioperative nurse have tried to worked together and share task based on common practice or skill, but the job description are still remain unclear. Both of them are still not understands about their placing parameters. Because of the unclear job description and not understanding the role ambiguity is created and misunderstanding can arise. As quoted by Rushmer et al (2005,p.80) said, ‘when the limits (boundaries) of sharing are ignored, nothing is clear and certainty is lost, the ability of collaboration to prepare realistically for their work together is gone where one of the parties ends up doing all the work, or all the unpleasant parts of the work’. Miers et al (2009) revealed, that the nurses are key to the success of inter-professional team. The effective of inter-professional also mentioned in the NMC code of conduct (2008), where the competencies that set by a mentor able to maintained professional boundaries and coordinate learning in an working environment and in an inter-professional working. Because shortage of staff especially nurses, some of the general anaesthesia  nurse are need to cover more than one operating room at the same time. When GA nurse are needed in the other operating room, the circulating nurse who worked in that particular operating room will had to act as a GA nurse. At the other hand GA nurse also can act as a circulating nurse when the job is compromised. As stated in NMC code of conduct (no date), ‘a nurse had to have advance skilled as well as increased knowledge’. Even though the circulating nurse does not have experience and skill as a GA nurse, it is they responsibilities to learn and gain knowledge and skill as a GA nurse. In Malaysia Nursing code of conduct (1998.p2), quoted ‘that nurses are responsibilities and accountability for her owns nursing judgement and action. When delegating work, the nurse remain accountable for the work done and appropriate supervision and support and guidance to be given to her’. The circulating nurse needs to be supervised and teach by the senior nurse who had the experienced or qualified as a GA nurse before she act and helped as a GA nurse. Also quotes by Nursing and Midwifery council (no date), ‘nurses must always be aware of their limits and ability and role boundaries, acknowledge their professional limitation and make accountable for their decision making and ability to work in a safe and effective manner’. This is reflected in the following paragraph of the Code of Conduct (2008), which states that ‘the nurse must have the knowledge and skill for safe and effective practice when working without direct supervision, recognise and work within limit, keep knowledge up to date and take part in learning and practice that maintain and develop your performance and competencies’. Although the nurses considering working in the position not related to their job, they have to fulfilled their task even though their do not have required registerable in that possess. For example although a registered nurse may work in operating theatre as a GA nurse or circulating nurse, they must not necessary to have a post basic course and qualified anaesthesia course. The environment also influenced the role of professional boundaries in my workplace. The nurses who work in operating theatre are abiding by nursing policies and regulations. In the operating theatre we also have our standard of practice called standard operating procedure where all the  nurses will follow the standard of practice procedure while performing their job. According to Brown (1998), Read (1999), Hamric (2000), Styles & Lewis (2000) cited in Lukosius et al (2004, p522), quotes’ that environment influence the development boundary in nursing roles, including work environment, policies and procedure, scope of practice, work schedule and work practice can influence the new roles in nursing practice’. Creating boundaries is a good way to keep professional relationship among the GA nurse and the perioperative nurse. The professional relationships are based on trust, respect, meeting the need of client and the appropriate use of power. According to National Council of State Boards of Nursing (no date) quotes, ‘that the power of a nurses comes from his/her professional position’. According to Retzklf (2012), when nurses show respect to each other, professional task, patient safety and nurse feeling of being part of the team are improved. However study has done by Lowe et al (2013), he suggest that once other staff fam iliar with the task given and their role, they are more comfortable working with other colleagues. Convesly, when nurse do not acknowledge of each other, competence or disregard their suggestion , unhealthy competitive attitudes can develop, colleagues can began to mistrust each other and the nurses can lose their interest in the nursing profession. Most nurses are aware of of blurring boundaries in professional practice but they still need to touch other professional discipline with permission and with clear instruction due to the role uncertainty and role ambiguity. As quotes by Alberta Association of registered nurse (2005, p.3),‘that a registered nurse in any role can ensure that professional boundaries are respected by applying the following guideline to their nursing practice as appropriate for their role’. This happen in my workplace where the perioperative nurse and the Ga nurse will work according to our nursing practice standards. Health providers can choose to change or develop new disciplinary boundaries after identified new areas of work according to their interest of work such as an advance practitioners nurse in anaesthesia or as a clinical nurse to gain more knowledge and skill in their own field. According to Chang et al (2011,p3), that the advance practice nurse position is a result of changing healthcare  needs and positive effects from this new roles have been widely document, improve patient out came and increased patient satisfaction. But in Malaysia there are still challenges in developing and implementing of advance practice nurse role. I hope there will be implement in the future. However, according to Witz (1992) cited in Nancarrow et al (2005) revealed his theory working in workforce in four direction; diversification, specialization, horizontal substitution and vertical substitution allow any healthcare provider to change their disciplinary boundaries and identified a new areas of work. Boundaries are important in successful professional project. It is good to have boundaries among health care workers but it is has to be in the positive way and within limits. Boundaries are also important for staff well-being , staff can develop wider expertise, gain knowledge of the new role and skills, contribute actively to new development, provide cross over and for effective client service.

Proposal Eye Clinic System

Table Content 1. Introduction †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 3 2. Planning Phase 1. Problem statement†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 4 2. Objective†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 4 3. Scopes 1. User Scope†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 5 2. System Scope†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã ¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 5 3.Software Requirement†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 6 4. Analysis Phase 1. Methodologies†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 6 1. Planning†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 2. Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 3. Design†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â ‚¬ ¦ 7 4. Implementation†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 7 5. Diagram 1. Flow chart†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ – 15 2. Entity Relationship Diagram (ERD)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 16 3. Data Flow Diagram (DFD)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 17 – 19 6. Conclusion †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 20 7. Appendix 1. Interface design†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 21 – 42 INTRODUCTION LaserPro Eye Centre Clinic System is a system where it is an eyes specialist clinic and is a place where the patient gets supervision from doctors about eyes diseases.Laser Pro Eye Centre clinic system is having unstable and lack of capability in managing the clinic. For example, this system cannot store the information of the patients and the diagnosis of the doctors. This is due to they are still using the manual ways in handling their patient records. Therefore, they will need to look for the records and it will be troublesome if the records have been kept for a year. Besides that, there will be a need in calculating the medical fees. It will be not efficient if they are still using the manual way to do the calculation.After that this system also will print the receipt and the report. Therefore, this system is developing to make the management of the clinic more systematically, easier and smooth. This clinic will do some charity, like didn’t count the consultation fee for all the patients, the poor people also afford to pay the medical fee. Because some patient not affordable to pay the expensive medical fees, they will choose don’t want go for treatment, maybe will cause the disease become serious.This system is a system were using the first come first serve method, so it will not provided appointment for the patients to book the appointment, because this is not fair for those walk in patients if they come early in the morning but because of the appointment patients, they have to wait until doctor finished the appointment patients first only diagnose them. In this system, I will include some modules. These modules are login, searching for the staff information, product information, and patient information, calculation for medication fee, delete and update module, clear, print receipt PLANNING PHASE Problem StatementThere is a few problem that occur if there is no systematic system for this clinic. It will be taking longer time to look for the records of the patient and medical dispenses. Besides that, it also require larger storage place, not environment friendly since they are using papers in keeping the records and the inactive records which have been put aside must have been lost. Besides that, some of the records are missing due to the large amout of patients record or information. In addition, manual method which required many processes such as finding old details that have been kept for a year is quite troublesome.OBJECTIVE The main purpose is to automate LaserPro Eye Centre clinic management system. The derivative are as follows: †¢ To automate the staff information system. †¢ To automate the product information system. †¢ To automate the patient information system. †¢ To automate sales report and product list. †¢ To automate the calculation of the medical fee. SCOPE User Scope: The target user s of this system are the doctors and nurses of LaserPro Eye Centre Clinic System. With this system,admin are able to : 1. Login into the system using security password. . View, update, add, and search details of staff information. 3. View, update, add, delete, and search details of product information. 4. View, update, add, delete, and search the patient information. 5. View sales report, and stock report according to overall sales, by day. Print out the report. 6. Calculate for the medication fees and print the receipt. With this system, staffs are able to: 1. Login into the system using security password. 2. View, update, add, and search details of staff information, but can’t update particular details. 3.View, update, add, delete, and search details of product information. 4. View, update, add, delete, and search the patient information, but can’t add or update the treatment of the patient. 5. View sales report, and stock report according to overall sales, by day. P rint out the report. 6. Calculate for the medication fees and print the receipt. System scope: The system use in LaserPro Eye Centre and its major function are: 1. Security password is required to allow admin and staffs to login into the system. 2. Store records of staff in database. 3. Store details of product in database. . Store details of patient in database. 5. Can calculate the medication fees and print the receipts for the patient. 6. Searching function which enables the admin and staff to look for patient records. 7. Help function to guide user in using this system. Software Requirement: 1. Microsoft Visual Basic. Net 2008: use to create or build interface of †LaserPro Eye Centre Clinic System†. 2. Microsoft Office Access 2007. 3. Microsoft Office Visio 2007. ANALYSIS PHASE Methodologies The methodology that was used to create the LaserPro Eye Centre is the System Development Life Cycle (SDLC).It comprises of 4 stages which are planning, analysis, design and impl ementation. PLANNING †¢ The system is built for easily search and find needed information of the clinic for the Admin and the staff of the clinic. †¢ The users would want search and find the staff information, patient information, product information in a quick and effective way. And also calculate the medical fee for the patient. †¢ The system is to be built by using the Visual Basic. Net programming language from the Visual Studio. Net software. ANALYSIS The users of the system are people who want to search, add, update, clear and delete the staff information, product information, patient information. †¢ The LaserPro Eye Centre will display the staff information, product information, patient information, calculation for medical fee, and the sales report that the users searched. †¢ Besides, there is a print button to let the user print out the receipt of the medical fee, sales report, product information the users has counted and searched. †¢ The syste m can only be used in LaserPro Eye Centre Clinic. DESIGN In the manager menu and the main menu, the users can select the staff, product, and patient information that they want to search or update. †¢ When the users choose to search the information, the information will be display. †¢ The users can calculate the medical fee using the calculation page. After calculated the medical fee, also can print out the sales report and the stock report. †¢ When the users choose to update the information, the users are allow to add, update, edit and delete the information. †¢ They can exit the system any time they feel like doing so.IMPLEMENTATION †¢ The system is supposed to be delivered by the 14th week and presented on the 15th week. †¢ The system is test before deliver. Flow Chart Login [pic] Forget Password [pic] Manager MenuMain Menu [pic] Staff Information [pic] Product Information [pic] Patient information [pic] Sale Information [pic] Sale Calculation [pic] E ntity Relationship Diagram (ERD) [pic] Data Flow Diagram (DFD) Context Diagram [pic] †¢ Level 1, Process 1 and Process 2 : [pic] †¢ Level 2, Process 1, and Process 2 [pic] †¢ Level 1, Process 3 and Process 4 : [pic] CONCLUSION:After going through all the processes and procedures involved, I have succeeded build the LaserPro Eye Centre Clinic System. With this system, users will no longer have difficulty in searching, editing, adding, calculating and deleting the details that they wanted. Besides that, they can save their time and easy in doing so. This system is created for two users to use which are admin and staff. Other than that, these systems have some feature that can be use and seen by staff so these systems can be avoiding the staff to see other user feature. Besides that, if user have forgotten their password. They can