1.Using Carrol’s pyramid of CSR and information from the case study, identify the corporate social responsibilities of Philip Morris International in the context of its operations in North Carolina. In your view, discuss why these responsibilities are important to Philip Morris International?

The US children working in tobacco fields: 'I wanted to help my mama'

Luis is just 14 years old, but he already has an exhausting, dawn-till-dusk job. Last summer, he started working in tobacco fields in North Carolina.

Even though Luis is just a child – too young to buy cigarettes – it is legal for him to work here in the US.

The job pays about $7.25 per hour.

Monday through Saturday last summer, when he was not in school, he rose at 5am, dressed in long sleeves, jeans, boots, gloves, a hat and a plastic poncho, and waited for a van to drive him to fields as far as an hour away. He came home around 7pm. This is a typical schedule for laborers in this tough and dangerous job.

Workers in tobacco are vulnerable to heat sickness, in temperatures which regularly reach 32C (89F); they risk injuries from sharp objects; and, if the Trump administration has its way, children will return to using the most toxic agrochemicals.

Then there is the plant itself. Tobacco naturally contains water-soluble nicotine. This makes morning dew or overnight rain a vehicle for huge doses of nicotine. Workers are regularly exposed to six cigarettes’ worth of nicotine per day, one study found. This can result in acute nicotine poisoning, called green tobacco sickness, characterized by nausea, vomiting, headaches and dizziness.

“I wanted to help my mama,” said Luis. He wanted to work, he said, “to get school supplies, so she doesn’t have to waste money”. Luis is the son of a cervical cancer survivor. He started to work when his mother, a waitress, was too ill to hold a job. (The Guardian has changed the names of workers and their families in this report.)

“It’s heavy work, very hard,” said Luis’s mother. But, she said, “there’s no choice”. Children need to help buy “clothes, shoes, their own things, things they need”. She said it would be “better when they were older, but he started because I had cancer ... He was helping me as well as my older son.”

In the US, lax laws and an informal economy in which landowners are removed from hiring laborers allow teens to work growing and harvesting tobacco. This contravenes some tobacco companies’ own policies, which often prohibit children from performing hazardous work.

“There’s a lot of 14-, 15-year-olds working in the fields,” said Antonio, a 19-year-old who has done so since he was 15, a history confirmed by his mother. “They need money or they want to work,” Antonio said.

Altria, parent company of Philip Morris USA, which produces Marlboro cigarettes, said growers were “prohibited from hiring those less than 16 years of age, and may only assign hazardous duties to workers 18 and older. Both are above the legal requirements. We require parental consent for those under 18 working in tobacco farming.”

The company also said it reviewed all growers every three years. In 2017, it found only one case of child labor, in which a farmer hired two 15-year-olds.

“While the individuals were no longer employed by the grower, the contract requirements were reviewed with the grower to strengthen their understanding of the minimum age requirement,” the company said. The company also said it had hired third-party assessors to monitor labor conditions.

Miguel Coleta, director of sustainability for Philip Morris International, said the company had been “making progress in tackling complex labor issues on farms supplying to PMI and our standards exceed US in many areas”.

“Challenges remain, and PMI continues to work with Verité and the Farm Labor Practices Group on systemic issues associated with child labor, grievance mechanisms to protect workers’ rights and to achieve meaningful improvements on the ground,” said Coleta.

In 2015, PMI adopted a new leaf-buying model in the US, and it now buys through the third-party leaf buyers Alliance One International Inc and Universal Leaf North America. At the time, Human Rights Watch said the move would improve labor conditions on US farms.

The Guardian interviewed several teens, parents, and labor organizers for this story. They described a picture in which child labor was commonplace. However, many said they depended on their children’s income to make ends meet. Many of those interviewed also work in other crops, including picking cucumbers, peppers or other vegetables.

“It’s the fact that we have to do it, because there is no alternative,” said Laticia Savala, a labor organizer with the Farm Labor Organizing Committee (Floc) in North Carolina. Floc does not support outlawing child labor in fields, because organizers feel it would harm families who depend on children’s income. However, needing the money does not lessen the harm.

“What mom wouldn’t want their kids studying [rather] than working in the fields?” asked Savala. “You’re forced into doing something.” If labor conditions on farms “were better, probably child labor wouldn’t exist”.

The world’s largest tobacco-producing countries span the globe. They include Brazil, China, India, Indonesia, Malawi, Pakistan and the United States.

Together, North Carolina and Kentucky produce 70% of the 700m pounds of tobacco grown in the US each year. Only 0.04% of US farmland grows tobacco, but the United States is still an international juggernaut, the fourth-largest producer in the world.

North Carolina is just one part of a global supply chain that feeds cigarette makers with tobacco leaf. However, the value of tobacco farming is dwarfed by the value of the global tobacco products. Tobacco farming was worth $19.1bn in 2013. Once leaf is manufactured, marketed and branded, tobacco products were worth $783bn the same year.

North Carolina’s farmers employ mostly Latin American workers, who toil in fields owned by white, ageing farmers. The US does not grant agricultural workers collective bargaining rights and workers are sometimes undocumented. Workers are vulnerable to wage theft, exploitation and dangerous working conditions.

Because children work in an informal economy, there is no data on how many might work in fields in summer months, or even when they should be in school. A 2014 report by Human Rights Watch (HRW) was the first in recent memory to ignite debate about child labor in tobacco in the US. The advocacy group followed up the report in 2015, and found little had fundamentally changed in fields.

“If you appear younger than 16, they’ll ask,” said 19-year-old John about children working on the fields. “But otherwise, no,” they don’t ask. Many contractors, one mother said, encouraged children to lie about their age.

Attempts have been made to regulate tobacco growing in the past. In 2012, the Obama administration attempted to make it illegal for children younger than 16 to work in tobacco. But the Department of Labor backed down after Republicans falsely argued the measure would prevent children from working on family farms.

At the state level, as recently as 2017, the Democratic Virginia delegate Alfonso Lopez tried to introduce a bill to bar child labor on tobacco farms. He was blocked by Republicans.

“If this was your kid, would you be OK with having them work in this job?” Lopez asked at the time as the bill was shelved. “Would you? I don’t think you would. So why is it OK for kids you don’t know to do this job?”

When criticism of child labor on US farms reached its peak in 2014, Philip Morris International hired a company to audit its supply chain. It found children working in hazardous conditions on 16% of the US farms it visited.

However, auditors concluded: “The root cause of many labor related issues in the US is the lack of sustainable, reliable workforce exacerbated by poor US immigration policies.”

The US has signed an international human rights convention meant to protect children “from economic exploitation” and work likely “to be harmful to the child’s health or physical, mental, spiritual, moral or social development”. To that end, it encourages trading partners to meet these standards, and publishes an annual report on the “worst forms of child labor” around the world.

One country singled out in the report was Malawi, visited by the Guardian earlier this year as part of an investigation, where children “continue to engage in the worst forms of child labor, including in the harvesting of tobacco”, the most recent report by the US Bureau of International Labor Affairs said.

The tobacco industry, through its Eliminating Child Labor in Tobacco Growing Foundation, agrees “in principle” children should be prohibited from hazardous work, “particularly the use of machinery and agrochemicals by children in tobacco farming”.

The Trump administration, meanwhile, is hoping to further deregulate farm labor. Rules put into place after the 2014 HRW report are being rolled back by the US Environmental Protection Agency, which is examining whether children should again be allowed to work with dangerous pesticides on farms.

“I’ve worked in the field as well; it’s very difficult. For a young person it’s worse,” said Antonio’s mother, a 37-year-old with three sons who works behind the counter of a rural convenience store. Teens often prefer farm work to other work, she said, “because they’re given jobs despite their age”.

Dominance of American tobacco has waned in recent decades, as the tobacco supply chain has globalized. This and the deregulation of US tobacco price controls has encouraged consolidation. Where in 1978 there were 188,000 tobacco farms, today there are around 4,200.

“A lot of times they’re underage and they lie and say they’re 16 or 17, but they’re actually 13 or 14 years [old],” Antonio’s mother said. “It’s hard, but there aren’t any more options.” She said claims that child labor was not happening on tobacco farms were “a lie”.

• The names of workers and their families have been changed

PLEASE ANSWER AS A TEXT. DON'T WRITE ON A PAPER.

Read the article below and answer the questions.  Your answers should be written to address the question in a report format not questions and answers format. The rubrics for assessment is given  below.

Andrew Rehder, manager of 3M Co.’s respirator mask factoryin Aberdeen, S.D., got the call from headquarters on Tuesday, Jan. 21. He gathered about 20 managers and supervisors into a conference room, where they sat, unworried, less than 6 feet apart. Rehder told them that a new virus was spreading rapidly in China and that 3M was expecting demand for protective gear to jump.

The Aberdeen plant had already ramped up production of respirator masks in response to demand from first responders battling wildfires in Australia and contending with a volcano in the Philippines. Now, Rehder told his charges, Aberdeen would shift to “surge capacity.” Idle machinery installed for precisely this purpose would be activated, and many of the plant’s 650 employees would immediately start working overtime. “We knew it wouldn’t be a two-week blip, it would be longer,” Rehder says. “But I had no idea.”

This is 3M’s moment, one for which the staid, 118-year-old Minnesota manufacturing giant—the maker of Post-its, Scotch tape, touchscreen displays, and scores of other products—has been preparing for almost two decades. Coming out of the SARS epidemic of 2002-03, the company realized it wasn’t fully equipped to handle unexpected explosions of demand in the event of a crisis, or what it calls an “X factor.” It decided to build surge capacity into its respirator factories around the world.

Over the years, with X factors such as the Ebola panic and the H1N1 flu virus generating flash floods of demand, the company kept refining its emergency response. When the world started clamoring for respirator masks to help confront coronavirus, 3M was ready.

People everywhere are scrambling for ventilators, Covid-19 test kits, bleach, and toilet paper. But almost no item is as scarce—and as vital to addressing this medical emergency—as the N95 respirator masks made by 3M, Honeywell, Medicom, and a smattering of other companies. Without respirators, doctors, nurses, and other medical personnel are at increased risk of contracting the affliction they’re treating.

China, where this coronavirus originated, also happens to produce half the world’s respirators. As the outbreak spread, the Chinese government halted mask exports and demanded that all in-country manufacturers, including 3M, crank up production. Shortages swiftly developed as Covid-19 cases appeared in Asia, Europe, and the U.S., forcing health-care workers to reuse old respirators and cobble together ersatz masks from materials bought at craft stores. In America, states are bidding against one another for masks priced as much as 10 times the usual cost of 60¢ to 80¢ apiece.

3M can’t save the day on its own, but it’s promising a remarkably large contribution. The company has in two months doubled global production of N95 masks to about 100 million a month, and it’s planning to invest in new equipment to push annual mask production to 2 billion within 12 months. On March 22, Chief Executive Officer Mike Roman said in a news release that 3M had sent 500,000 respirators to hard-hit Seattle and New York City, and that it was ramping up production of hand sanitizers and disinfectants as well. Two days later, Roman said 3M would work with Ford Motor Co. to produce powered air purifying respirators, waist-mounted devices that blow air into helmets that shield wearers. Honeywell is also increasing N95 production, saying it will hire at least 500 people to expand capacity at a facility in Rhode Island.

Although businesses globally have emptied out, more than half of 3M’s 96,000 employees are still showing up for work in its factories and warehouses. “It’s been amazing,” says Rehder, who’s in the Aberdeen plant seven days a week, usually walking the floor, which is now marked with yellow tape to keep workers from violating the imaginary 6-foot infection barrier. “People are very proud to work in a place that’s making respirators, especially with the need that’s out there now.”

Pliny the Elder wrote of sulfur miners in ancient Rome using animal bladders to fashion the earliest face masks. Leonardo da Vinci imagined a mask soldiers could wear as they flung poisoned powder at enemies. Over the centuries masks evolved to counter smoke, smog, coal dust, and asbestos fibers. During the 1918 flu pandemic, San Francisco health regulators recommended that people wear masks in public places.

The N95 respirator is so named because, worn properly, it blocks at least 95% of airborne particles from entering a wearer’s mouth and nose, while still allowing respiration through the microscopically porous shell. This design protects a person from medical and other hazards; flimsier, looser-fitting surgical masks are intended to prevent the wearer from infecting others with expelled mucus, blood, or spit.

3M makes about two dozen versions of the N95, for different industrial and medical purposes. Generally they’re constructed from nonwoven materials—infinitesimal plastic strands blown together to form a random thicket that, under a microscope, “is going to look like pickup sticks,” says Nikki McCullough, 3M’s global leader for occupational health and safety. “If you’re a submicron particle, it’s quite the journey through there.” The filters can block invaders as small as 0.3 microns, or about 1/100th the thickness of a human hair. The virus is smaller than that, at about 0.125 microns, but it often travels within larger particles when an infected person coughs or sneezes.

3M started making dust respirators in 1972. Later versions became staples at construction sites, oil fields, coal mines, and factories, as well as at hospitals and disaster scenes. After the SARS outbreak sent demand soaring, Roman says, “We realized we didn’t have the ability to flex” production to adapt to the unexpected. “We had H1N1 after that, we’ve had forest fires and hurricanes, and all of those create a surge in demand.” So 3M set about rethinking the manufacturing process from one end of the supply chain to the other. Factories added assembly lines that would stand dormant until needed. Suppliers were put on alert. The company assembled emergency response teams that would leap into action whenever catastrophe beckoned: Harvey, Maria, the California wildfires.

Then came Covid-19. China’s respirator makers had largely shut down for Chinese New Year when the coronavirus started making headlines, leaving mask supply shrinking just as the need was poised to skyrocket.

“Basically, we were at the point where we needed to start every machine up. It happened pretty much instantaneously”

The supply chain team at 3M noticed early. “We monitor our demand constantly,” says Charles Avery, global value stream director for 3M’s personal safety division. “We knew we could be in for an X factor.” McCullough, who has worked on respiratory protection for much of her 23 years at 3M, began to worry when she saw Singapore and other countries taking precautionary steps even before they had many cases. “We started realizing how quickly this was spreading,” she says.

3M had another built-in advantage: Unlike many companies that have moved production to low-cost countries, it sources the materials for its respirators near its assembly plants and serves customers reasonably close by. “We make respirators in China for the China market, we make respirators in Korea for a little more than the Korea market,” Roman says. Each plant can ship respirators anywhere—pretty important in a pandemic—but day to day, a plant doesn’t rely on distant vendors subject to tariffs or export bans.

In the U.S., the facility at Aberdeen, a city of 28,000, was built in 1974. The 450,000-square-foot factory and a sister plant in Omaha together produce 400 million respirators of myriad types annually. Within the next year, they will be producing many more.

When Rehder got that call from his bosses in January, he says, “basically, we were at that point where we needed to start every machine up. It happened pretty much instantaneously. That’s what this plant does.” The facility quickly organized offsite and online job fairs. Hires had to undergo training and pass a medical exam before starting work. The payroll now counts more than 700.

Rehder has also been bringing in new equipment to build additional assembly lines. The mask components are readily available because most of them, including the filters, are made in-house. The lines that assemble respirator cups, filters, nose clips, and nose foam are loaded with robots and other automation, while humans tend to packaging and other tasks that allow more easily for social distancing. No workers have yet gotten sick, Rehder says. At home, his wife has been patient—though, he jokes, “when we try to sit down and watch a movie and I get six calls in between, I get a couple of looks.”

Tamer Abdouni is a Beirut-based consultant who facilitates the trade of, among other things, 3M respirators. Usually he can buy them for $1.25 apiece and resell them for a dime more. Lately the best purchase price he can get is $7.25. Even if he were willing to buy at that price, he says, selling respirators at multiples of his usual price during a pandemic would tarnish his reputation.

“3M makes the Rolls-Royce of masks,” Abdouni says. “People are holding stocks of masks and waiting for them to increase in value before selling them off. This is becoming very unethical. This is a war on coronavirus, and I don’t want to be a warlord.”

In the U.S., too, prices for personal protective equipment are being driven up in what has become a grim marketplace. It’s unclear whether some distributors are withholding masks as demand rises, but states are clamoring for every mask they can scrounge and must compete against one another to secure them. New York Governor Andrew Cuomo said on March 23 that masks the state usually buys for 85¢ now cost $7.

3M says it hasn’t raised respirator prices and can’t control what happens after it sells its products to distributors. Roman wrote to U.S. Attorney General William Barr on March 24 to offer 3M’s help in rooting out medical device counterfeiting and price gouging.

With demand soaring, 3M’s respirator sales could nearly double this year, to $600 million, according to William Blair & Co. analyst Nicholas Heymann. The company, despite its $32 billion in annual revenue, could use the boost. 3M has frustrated Wall Street in the past year with reduced earnings forecasts, sharp downturns in key markets, and thousands of layoffs. The coronavirus outbreak remains a threat to the broader supply chain and economy, and it could ultimately “make it more difficult for 3M to serve customers,” the company acknowledged in a regulatory filing this week. It also faces potential liabilities of as much as $10 billion, some analysts estimate, over its past use of PFAS, a group of chemicals that shows some associations with cancer. 3M’s shares fell last year even as the broader markets were advancing.

In Aberdeen, Rehder has more pressing things to worry about. “I just think,” he says, “as we’ve continued to see things spread across the world, it’s put more responsibility on us to make sure that every day and every minute we’re making every mask we can.” —With Riley Griffin

Q) Explain the key success and supply chain advantages 3M has that enable the company to respond to a high demand of masks amid corona virus outbreak.

How 3M Plans to Make More Than a Billion Masks By End of Year

Case analyses are expected to show critical thinking and be adequately supported with more than one cited reference and in-text citations to support your thoughts. One of these references may be the textbook. Each paper should include a synopsis of the issue at hand and an analysis of what should happen next for the particular situation. Each paper will be written using APA format and be at least 1-2 double-spaced pages (not including cover sheet, references, etc).

Case

Susan Berry just returned from a national conference on compensation and benefits where she attended a session on health savings accounts (HSAs). Susan is the human resources director at Frontline PR, and the company has been struggling with the cost of health care insurance. After speaking with several experts at the conference, Susan now thinks an HSA might be a viable option for the company. Frontline PR is a public relations firm located in the Northeast that employs close to 150 people in four different offices. Public relations professionals make up most of the staff, but the company also employs a complete administrative and operations staff. All of Frontline’s employees work full-time schedules and are eligible to participate in its health care insurance plan. Frontline currently offers a standard fee-for-services health care insurance option. The plan has a modest deductible of $300 per year and a 20 percent coinsurance requirement. In addition, the company offers a flexible spending account (FSA) that allows employees to set aside pretax earnings to pay for the deductible, coinsurance, and other medical expenses. Susan is considering offering an HSA along with a high-deductible health insurance plan instead of the current insurance plan and FSA. At the conference, Susan learned that making such a change could result in significant cost savings for a company. The high-deductible health insurance plan would cost a lot less for the company than the standard fee-for-services plan that Frontline currently offers. While Susan suggests that Frontline make contributions to each employee’s HSA, the overall costs for the health care benefit would still be less than its current option. Beyond cost savings on premiums, many believe that consumer-driven health care tends to reduce overall health care costs. Some of the experts Susan spoke to at the conference stated that when employees have a greater say in their health care decisions, they make wiser decisions and do not spend as much on health care. Susan has discussed the HSA option with Frontline’s director of finance, Allison Jones. From the financial perspective, Allison agrees that the option would be a good step to start controlling health care costs. However, as an employee who would use the benefit, Allison isn’t so sure that an HSA with a high-deductible health insurance plan is the right option for the company. Based on Susan’s initial explanation, Allison didn’t really understand how the HSA worked. Further, she was concerned that she would have to spend more out of pocket on her own health care. Susan is convinced that the HSA option would offer a significant cost savings to Frontline. However, after her discussion with Allison, Susan is still unsure if it is the right path to recommend for her company.

Questions:

10-6. What are some advantages of implementing the HSA option?

10-7. What are some potential disadvantages of the HSA option?

10-8. What do you recommend? Why?

Case Study

In Francisco Automotive Manufacturing Plant, a large number of engineering activities are carried out in a wide range of areas. These activities include design, production of parts, assembly, testing, and quality assurance.

Many of the manufacturing processes in the plant are performed using automated technologies and equipment. People also perform some of the manufacturing tasks and the plant employs over 400 workers. The decision on whether people or machines will be used for a particular task is dependent on many factors, including costs, time, quality and worker health and safety.

The plant considered here produces a many parts for vehicles and assembles them. Among the parts produced are engine materials and parts, pumps, fans, some exterior parts, and electronics components. The plant normally operates three shifts per day and has production lines including machining equipment, conveyers and overhead cranes, punch presses, and paint-spray booths. The plant utilizes electricity and natural gas extensively.

A number of workers at the plant have over the last six months been subject to several different health problems. The following information has been received by the head engineer at the plant.

a) In an assembly area that was installed recently, workers have to bend to the ground throughout the    day to attach several small parts onto a large and heavy vehicle component. Some workers have          begun to develop lower back pain, likely due to the repetitive bending. The problem has become so      severe for one of the workers that he has been told by his doctor to stay off work for two weeks so his     back can recover. The manufacturing engineers who designed the assembly operation had wanted to    use an automated system, but that option was deemed not to be economic. So they used a manual                   operation, but did not take into account industrial ergonomics, as they had no expertise in that               discipline.

b) An increased incidence of respiratory illnesses has been reported over the last month by workers       operating near the paint-spray booths. Many of the substances used in the booths (paints, solvents,            etc.) are known to be causes of the observed respiratory illnesses. But the workers are not supposed to come into contact with any of the substances because the paint-spray booths are designed to        ensure that all materials exit the plant through a high capacity ventilation system and that no materials can leak back into the plant. No tests had been carried out on the ventilation system, or on            the air quality around the paint spray booths, so it is uncertain whether or not there have been any                      leaks into the plant from the paint-spray booths.

c) In an area of the plant where metal cutting occurs and workers use protective eyewear, workers have reported minor eye injuries. The area in question is one where it is common knowledge that the workers do not routinely use the protective eyewear. It is often observed to be hanging on nearby hooks or to be loosely hanging around the necks of workers. Workers complain that they find the protective eyewear uncomfortable and do not think it is needed or important. The plant manager knows of this behaviour but overlooks it, since enforcing the use of the protective eyewear seems may make the workers unhappy and, consequently, less productive. That, he feels, could render the plant non-competitive.

Questions:

1) Which of the unsafe conditions and acts identified in part b are (a) of a technical nature,

            or (b) related to human behaviour or management?

2) What are some steps can be taken to rectify the health problems observed?

Week 6 Assignment

Fill in the blanks:

1. A pharmacist or chemist was formerly known as a(n): __________________
2. The ______________ was the original or primary system for calculating and measuring medication dosages.
3. A(n) ______________________ is the unit that is used when measuring anything that has mass or weight.
4. A(n) __________________ is the fundamental unit for volume and is used when measuring liquids.
5. A(n) _________________ is the fundamental unit for length and is used when measuring distance.
6. The _________________ is used throughout the world and is the primary system for measuring weight, volume, and length (area).
7. A(n) __________________ is a graph that illustrates a relationship between two known values.
8. The medical industry considers the __________________ the most accurate method of calculating drug dosage for infants and children up to 12 years of age.
9. The term ____________ means to switch from one unit to another.
10. _____________________ is known as the numbers used to identify the manufacturer, the product, and the size of the container.
11. List and describe the 3 types of human insulin that are available.
    1. #1
    2. #2
    3. #3
12. If a physician prescribes 2 Tbsp twice a day, how many days will an 8 oz. bottle last?
    1. Two days
    2. Three days
    3. Four days
    4. One week

13. Dosages of insulin are always measured in which of the following:
    1. Cubic millimeters
    2. Grams
    3. Micromilligrams
    4. Units

14. A child weighs 66 lbs and the physician has ordered a daily dose of 30mg/kg of body weight. The daily dose should be divided into three equal doses. Which of the following dosages will be given to the patient PER DOSE?
    1. 300 mg
    2. 600 mg
    3. 900 mg
    4. None of the above

15. The physician orders Amoxicillin 0.05g. Available is Amoxicillin 150mg/5Ml. How many milliliters (mL) will you give the patient? (Round to the nearest tenth)
    1. 1.5 mL
    2. 1.7 mL
    3. 2 mL
    4. 1 Ml

16. Match the term with its definition and place the correct letter in the first column.

17. Calculate the correct number of tablets or capsules to be administered per dose. Tablets are scored. Refer to the prescription abbreviations in Appendix A in the textbook to help you read the orders. Also refer to the Joint Commission’s “Do Not Use” list and the ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations in Appendix B of the textbook.
    1. Order: 0.5 g of Duricef p.o.r., Supply: Duricef 500 mg tablets

Answer: Give the patient ___________ tablets of Duricef (500 mg strength)

2. Order: Motrin 600 mg, Supply 300 mg tablets

Give the patient ___________ tablets of Motrin (300 mg strength)

3. Order: Inderal 15 mg, Supply: Inderal 10 mg tablets

Give the patient ________ tablets of Inderal (10 mg strength)

4. Order: Tylenol 0.5 g, Supply: Tylenol (acetaminophen) liquid 500 mg in 5 mL

Answer: Give the patient _______mL of Tylenol

Topic:How does handwashing prevent intensive care unit patients in the hospital from nosocomial infection compare to usage of hand sanitizer to reduce the risk of infection in the first two weeks?

DIRECTION: Please review my paper

Course project

In recent years, attention to health care associated infections (HAIs) formerly referred to as nosocomial infections. The impact of infectious disease changes through time as microorganisms mutate, as human behavior patterns shift, or as therapeutic options change. HAND HYGIENE: The most frequent cause of infection outbreaks in health care institutions is transmission by the hands of healthcare workers. Hands should be washed or decontaminated frequently during patient care. When hands are visibly dirty or contaminated with biologic material from patient care, hands should be washed with soap and water. In this paper we will emphasize the effectiveness of hands hygiene compare to hands sanitizer.

PICOT

In intensive care units and other locations in which virulent or resistant organisms are likely to be present antimicrobial agents such as chlorhexidine gluconate, iodophors, chloroxylenol and triclosan may be used. Effective hand washing requires at least 15 seconds of vigorous scrubbing, with special attention to the area around nail beds and between fingers, where there is a high bacterial load. Hands should be thoroughly rinsed after washing. Because they are formulated with emollients, they are usually better tolerated than other agents, and because they can be used without sinks and towels. Hand washing or disinfection reduces the bacterial load and decreases the risk of transfer to other patients.

Hands Hygiene and hand sanitizer

When hands are not visibly soiled, health care providers are strongly encouraged to use alcohol-based waterless antiseptic agents for routine hand decontamination. These solutions are superior to soap or antimicrobial handwashing agents in their speed of action and effectiveness against microorganisms. Reduction in the infection rates and microbial counts on health care providers.Also, improvements in skin conditions of health care providers and reduction in infection rates. Other practices such as frequency and quality of hand hygiene reduces the risk of cross-contamination.

Integration of evidence

Direct observation of hand hygiene by health care providers is considered as the " golden standard" of measurement methods. Observation helps to allow which hand hygiene products are used, the thoroughness of cleansing, the tools and techniques used for drying, the use of gloves,and whether the staff are performing hand hygiene whenever there is an opportunity to do so. This method helps to give a feedback when improvement is needed. MEASURING PRODUCT USE: Measuring the amount of soap, alcohol-based hand rub and paper towels that health care workers used is an indirect way of estimating staff adherence to hand hygiene guidelines.

Implementation of methods

Effective hand washing requires at least 15 seconds of vigorous scrubbing, with special attention to the area around nail beds and between fingers, where there is a high bacterial load. Hands should be thoroughly rinsed after washing. If hands are not visibly soiled, health care providers are strongly encouraged to use alcohol-based waterless antiseptic agents for routine hand decontamination.

Conclusion

Hospital acquired infections (HAIs) is a major safety concern for both health care providers and the patients. Considering morbidity, mortality, increased length of stay and the cost, efforts should be made to make the hospitals as safe as possible by preventing such infections.The best and most effective way to prevent is perfoming hands hygiene to avoid spreading diseases such as C.diff which is resistant to alcohol base hand sanitizers.

KURUKAHVECİ MEHMET EFENDİ

Established in 1871 in Eminönü-İstanbul by Mehmet Efendi, a young 25-year-old entrepreneur, Kurukahveci Mehmet Efendi started as a local coffee roaster and grew to become a national coffee manufacturer whose name is synonymous with premium-quality coffee, be it Turkish coffee, filter coffee, or espresso. After Mehmet Efendi’s death in 1931, the family business passed to his three sons. The family formally took “Kurukahveci” as their last name in 1934. Passionately attracted by the innovation and product development side of the business, the Kurukahveci family overlooked the importance of monitoring the competitive surroundings, market dynamics, and the purchasing behavior and consumption habits of customers. With competition intensifying and competitors investing heavily in venues and product mix, Kurukahveci Mehmet Efendi found itself struggling to maintain its sales and share despite the growth of the Turkish coffee market locally or overseas.

To remedy this situation, management realized the need for reliable market information as a basis upon which to base their new competitive strategy. According to Marketing Manager Hasan Koç, “a valuable decision management took which had major implications on our decision-making process was subscribing regularly to the coffee category of the A. C. Nielsen Retail Audit. The report revealed huge weaknesses in Kurukahveci Mehmet Efendı’s distribution and market coverage. It also shed light on the presence and share of each major player in the category across different geographical regions and trade channels with in-house analysis of their strengths and weaknesses.”

To ensure proper coverage, Kurukahveci Mehmet Efendi found that a huge investment in human capital, vans, and technology was required, which would not be reasonable for such a limited product portfolio. In 2010 a strategic decision was made to outsource the distribution operation to a specialized national distributor that can ensure a proper Turkish market presence for Kurukahveci Mehmet Efendi products.

Change was not limited to the distribution strategy. Management also decided to revise all its marketing mix elements including product packaging, pricing, and communication. Mustafa Kamil Kurukahveci noted that “the exercise was led by a team of professionals from leading regional research houses who initiated tailor-made studies of the existing market conditions, trends and techniques in packaging, pricing, and communication, and to suggest recommendations for the launch of the re-engineered Kurukahveci Mehmet Efendi’s product line.” This undertaking resulted in the architecture of the Mehmet Efendi brand being changed, with color coding to emphasize the heritage, and in repositioning the brand through innovative packaging and a creative but focused communication, pricing, and distribution strategies. “The right positioning is the key to the success of every brand,” said Abdullah Kıratlı, General Manager.

Management also focused on export markets. Market research reports by Euromonitor provided valuable insights about macro-country indicators as well as specific market information related to coffee, such as volume, value, trends, consumer habits, and competition. In addition to field visits by marketing and top management, the management used that information to identify promising regional and world markets and to decide how to penetrate these potential markets.

Kurukahveci Mehmet Efendi’s current manufacturing facility handles all the export markets, focusing on serving the Central Asia (Kazakhstan, Kirgizstan, Azerbaijan, and Turkmenistan), as well as the Gulf countries in the Middle East, North Africa, Europe, and the Americas.

“Market intelligence and research can never be 100% accurate; yet it is highly insightful and enlightening,” concludes Cem Kurukahveci, owner and major shareholder of Kurukahveci Mehmet Efendi.

QUESTIONS

2) Identify the sources of secondary data that Kurukahveci Mehmet Efendi utilized. How were these sources helpful? (2pages)