Electronic Health Record Essay Example for Free

Electronic Health Record Essay An Electronic Health Record (EHR) is a system of records that are electronically managed, providing longitudinal information of the patient’s health.   The information is generated during one or more encounters with the patient.   Information can be recorded and stored under several sections including demographics, encounters, interventions, treatments, immunizations, prescriptions, laboratory and imaging data, etc.   The EHR is not only a recording system, but also helps in clinical decision-making.   It has several features incorporated such as providing reminders, precautionary measures to be taken, alerts, evidence-based information, tips in improving prognosis and the quality of care provided.    An EHR system can function within one department of the enterprise, in the entire enterprise, or even between several enterprises within a nation or region.   EHR’s can be customized depending on the type of department requiring them and the purpose for its use (NIH NICRR, 2006 Gurley, 2004). Advantages of the EHR system:- †¢ Patient information can be stored for longer periods and would occupy lesser space †¢ Patient information can be accessed from any point in the hospital and also from one hospital to another, if needed †¢ Patient information can be secured and confidentiality can be maintained (as a particular user would be accessing the system with a username/password, and would get information only about his/her patient) †¢ Information can be updated from any of the user points †¢ Several features such as alerts, reminders, etc, which are very useful to the user can be enabled in an EHR system †¢ Built-in intelligence of the EHR would provide several benefits to the physicians such as providing evidence-based information, potential drug reactions, etc †¢ The quality of care can be improved †¢ The requirements and standards set by accreditation organizations, legislations and insurance companies can be more easily met using an EHR system †¢ Potential life-threatening situations and hazardous drug reactions can be better prevented and managed using an EHR system †¢ The patient workflow can be effectively managed if an EHR system is present †¢ Communication between several structures of the healthcare organization can be improved (faster and more effective) †¢ Depending on the needs of the hospital, a customized EHR can be enabled †¢ Risk assessment, management processes and error identification can be better enabled using an EHR system (NIH NICRR, 2006 Gurley, 2004). Disadvantages of the EHR system:- †¢ Initiating and maintaining an EHR system may be very costly for the organization (however, the improvements in quality need to be considered) †¢ Training healthcare professionals in EHR use may be difficult (as it requires some amount of technical knowledge) †¢ Getting competent with the EHR system requires a sharp learning curve †¢ The EHR systems incorporated from one hospital may be different from another, which may hamper the flow of information – Lacks standard architecture and terminologies (effective interconnecting links need to be considered) †¢ Staff members may find it difficult to adopt to the clinical changes brought about through incorporation of an EHR system †¢ Slow systems may affect the workflow †¢ Risk of the system being hacked and data misused (certain standards should be compiled with and protocols need to be followed) (NIH NICRR, 2006 Gurley, 2004).

Joyce Campbell :: Short Stories Papers

Joyce Campbell Melissa Everett was sitting comfortably in her swivel chair staring down on the busy city of New York. She dreamily began talking to herself: â€Å"How lucky I am,† she thought. â€Å"My life is so perfect right now, my family supports me and I have great friends.† She calmly looks around her large office and thinks to herself, â€Å"And look how far I have come!† She thinks back to her struggles and to her climb up the companies latter. â€Å"Without the help of Joyce, I and several of the other female executives of Tie Technologies would not be here. How did she do it? I wonder how it was back then†¦.† Melissa eyes grew slightly heavy, her head filled with thoughts and she quickly slipped into a light sleep†¦. June 27th, 1957. The sun was out; the sky was blue, dusted with only a few white clouds. This morning was like any other morning: Typical. The sun was shining warmly onto the houses, cars and people of Apple Lane. Number 203, residence to Gregory and Judy Stephenson was a bustle. This newly built large brick home is surrounded with others identical to itself. In this suburban neighborhood, the streets are cluttered with children and mother’s offering goodbyes to their loved ones as the men commute to their work. Judy stands waving softly to the old Cadillac pulling out of the driveway. Her skirt blows into the air, and her wispy blonde bangs sweep to the side of her face. She holds her baby girl in her arms and touches the shoulder of the young boy below her. It’s very early, she dresses her children for school and shovels them out of the door an hour or so later. She crochets, bakes a few batches of cookies for her returning children, walks to the market to purchase the necessary items for dinner - baked potatoes, carrots and flank steaks - and decides to walk over to her friend Joyce's house. She arrives; unfortunately the bottom inch of her skirt has been caked with wet dust, and approaches a young woman with a big straw hat on reading quietly on her porch. It is routine. Judy sits down next to her takes out her new romantic novel and decides to go make herself cold lemonade.

Poor Liza Character in 20th Century Russian Literature Essay

It is no accident that the name that is attributed to the heroine in a number of Russian novels of the late eighteenth and nineteenth centuries is named after some derivation of the name Elizabeth. Karamzin is the first to revere this name in his work Poor Liza and it is this work that sets off a chain reaction that causes the occurrence of subsequent characters in Russian literature. This character can particularly be found in works such as Pushkin’s Queen of Spades, Griboyedov’s Woe from Wit, and even briefly in Gogol’s Dead Souls. At the time that Karamzin published Poor Liza, Russia had recently seen the reign of Queen Elizabeth I (1741-1761) who played a great role in shaping Russia’s identity and culture. Through a close reading of those Russian texts which include the Elizabeth character, an understanding of this name’s historic role in Russian literature can be achieved and its parallels to the monarch that this name evokes. Before tracing t he Liza name in the Russian texts, it is important to better understand the character traits and lives of the empresses after whom this name takes. The more significant of these being Queen Elizabeth of Russia as it was not long after her reign that Karamzin wrote Poor Liza. Elizabeth was born to Peter I of Russia and Catherine I of Russia; however due to the fact that her parents’ marriage was not publically acknowledged at the time of her birth, this would be a detail used to challenge her legitimacy to the throne by political opponents (Antonov, 104).In her outward appearance, Elizabeth delighted everyone, â€Å"with her extraordinary beauty and vivacity. She was commonly known as the leading beauty of the Russian Empire† (Antonov, 104). Politically, Elizabeth was seen as the heroine of the Russian cause as was attributed to her, â€Å"steady appreciation of Russian interests, and her determination to promote them at all hazards† (Rice, pg 121). Russia under Elizabeth’s rule reasserted her power over foreign repression as the country had been under direction of a number of German favorites and pres sure from the West. It was upon her coronation that a royal decree was issued stating, â€Å"the Russian people have been groaning under the enemies of the Christian faith, but she has delivered them from the degrading foreign oppression† (Antonov, 109). Elizabeth is also remembered for championing the arts and scholarship through the vast funding she poured into projects such as the Moscow State University, the Winter Palace, and the Imperial Academy of Arts (Antonov, 106). The image of Elizabeth is also painted by her deep devotion to religion in that she disengaged many of the legislations that her father had done to limit the power of the church (Rice 149). In many ways, Elizabeth I becomes the perfect root from which the image of the heroic Russian woman springs from as is later manifested in Russian Literature following her reign. The first time that Russian is introduced to the Liza character is in Karamzin’s Poor Liza which was published in 1792, following Elizabeth I’s rule . The main heroine, Liza’s, characteristics can be attributed to those of Elizabeth herself. The first of these similarities can be found in both of the female’s fathers. Liza’s father is described as, â€Å"a rather well-to-do settler, for he loved work, tilled the land well† (Karamzin, 80). The hardworking nature of the father can also be seen in the traits of Elizabeth I’s father, Peter the Great who’s restless work made Russia into an empire. However the greater likeness lies in the negative effects caused by each of the women’s father’s deaths. In Poor Liza, soon after Liza’s father’s death, â€Å"his wife and daughter grew poor†¦and they were forced to rent out their land for a pittance sum† (Karamzin, 80). Similarly, after the death of Peter I, â€Å"no royal court or noble house in Europe could allow a son to pay court to Elizabeth, as it would be seen as an unfriendly act to the Empress Annaâ₠¬  (Coughlan, 59). The lowering of stature for both Liza and Elizabeth made it difficult for both to find a fitting husband. In Liza’s case, lest she ends up marrying someone she does not love. When Erast and Liza are discussing the marriage arrangements that are being made for her to be married to a peasant boy and Erast asks if she would marry him instead, she says to him, â€Å"but you can never be my husband!†¦ I am a peasant girl† (Karamzin, 87). Since Elizabeth I was shunned from the royal courts after her father’s death and at the same time she could not marry below her so as not to lose the royal title, the empress died unmarried, as did Liza. However, this is not the only shared experience of the Russian heroines. Another parallel between the empress and Karamzin’s peasant girl can be found in their educational background. For a queen, Elizabeth I was considered lacking of the solid education needed for her role. This could mostly be blamed on Peter I’s focus on state affairs and her mother’s illiterateness and laissez-affair approach to her daughter’s studies (Antonov, 104). A comparable trait can be drawn in Liza, specifically when she is saying good-bye to Erast and she says, â€Å"Oh! Why do I not know how to read or write!† (Karamzin, 89). And so, both women were undereducated for the role they had come to fill, a ruler and a worried-sick lover. Taking a closer look at Elizabeth’s and Liza’s personalities it becomes evident that they share commonalities. For instance, when Karamzin first introduces his Liza character, he says that, â€Å"to soothe her mother she tried to hide the grief in her heart and appear at ease and gay† (Karamzin 81). This gayness can be also found in Elizabeth I as she was well known for her gaiety and playfulness as was evidences by the cross-dressing balls that she held at her court (Rice 136). Another example of their similar characters can be found in the virginal beauty and pious image created by both. Karamzin describes Liza as being a â€Å"rare beauty† (Karamzin, 80) and Elizabeth in her youth was as already mentioned the premier beauty of Russia in her day. It is also important to note the pureness in the aura created by Liza as she is unspoiled by the trivialities of high-society. The color white can be found in a number of images in connection with Liza, the first being the lilies of the valley which Liza sells at the market in Moscow (Karamzin, 81). These flowers are typically small and white in nature and by Christian are attributed to the tears of the Virgin Mary during the crucifixion of Christ, thus by having Liza the vendor of such flowers, she is placed into a wholesome and holy light (Krymow, 18). Another place in which the color white and purity is shown in connection to Liza is when Erast visits her home and says, â€Å"I am very tired. Would you have any fresh milk?† (Karamzin 82). Liza, â€Å"ran to the cellar, brought back a clean earthenware pot, washed it and dried it with a white towel, poured and handed the glass through the window† (Karamzin 82). Even when Liza falls in love she is described as having a , â€Å"pure, and open heart† (Karamzin, 85) and there are more images of purity and whiteness as is seen when the two lovers meet at night and, â€Å"they embrace – but chaste, shy Cynthia did not hide from them behind a cloud; their embraces were pure and sinless.† (Karamzin, 86). Karamzin also describes Liza through Erast’s eyes as a shepherdess, again evoking an image of purity (Karamzin, 86). Even when Liza gives up her virginity to Erast, Karamzin still evokes images of purity when he says, â€Å"like a lamb she submitted to his will in everything† (Karamzin, 89). These holy referents in Karamzin’s Poor Liza, create a sacred image out of the Liza character which is similar to the character traits of Elizabeth I. Part of the reason that the empress Elizabeth built so many churches was that at one point she was considering becoming a nun. For this reason The Convent was built and erected by her order (Bain, 138). She is also attributed to building the most number of churches as compared to any other Russian monarch, the most famous being the Smolny Catherdral (Bain, 138).In her religious devotion, and her unmarried life lie some of the stronger parallels to Karamzin’s Liza character from which the spring the lineage of the Liza characters. Following Poor Liza, other writers also began evoking the image of Elizabeth I in their writing. The next one being Griboyedov’s in his Lizzie character in Woe from Wit. Again the Liza character, in this case being Lizzie, is painted as a picture of pure virginal beauty. Lizzie’s outer appearance is described by Molchalin: There’s one thing I’m thinking of: These cheeks, these veins and all Have not yet seen the flush of love. (Griboyedov, IV.xii.4-6) In the last line, Mochalin especially points out the paleness of her skin which shows her virginity. Another similarity between Elizabeth I Liza, and Lizzie, is that they all reject or lovers who rank higher or equal to them. Lizzie for example pushes away Molchalin when he tries to embrace her (Griboyedov, IV.xii.51-52) and instead loves someone of lower or equal rank: So strange these people seem to be! She craves for him, he craves for me, And I’m†¦ the only one who’s scared of love, Barman Petrusha, my sweetest dove. (Griboyedov, I.xiv.4-6) Lizzie also rejects Famusov when he corners her in the hall and embraces. She is stern with him and shows little interest, despite his rank: It’s you who’s frivolous, let go, will you? Compose yourself, old man. This is corresponds with the relationship dynamics of Elizabeth I in that she was once betrothed to Prince Karl Augustus but he died before they could be married(Coughlan, 23). Instead of seeking a husband of equal stature, which proved difficult because she was not welcome in noble circles she pursued lovers in the military and service, eventually settling on a Ukrainian peasant in a church choir by the name Alexis Razumovsky (Coughlan, 59). Yet there are more similarities that can be traced between Elizabeth and Lizzie’s characters. Elizabeth I’s rule was marked by the extravagant balls and events who would throw. On average, her weekly balls would host approximately 800 guests and she would also often throw smaller parties for her court members (Rice, 135). Lizzie, like Elizabeth, also enjoys a celebrations and parties. For this reason when she is speak with Sofia she reminds her, â€Å"the holiday is coming! Time for fun!† (Griboyedov, I.v.1). Lizzie is referring to the get together that will happen in the play as it will give her a chance to see her beloved Petrushka. Following Lizzie’s character, the Liza image carried over next to Pushkin’s work, Queen of Spades. The Lizaveta character in Queen of Spades is reminiscent of the young Elizabeth I who was unpopular at the royal court. Lizaveta is first described to the reader as the â€Å"martyr† of the house as she was always being scolded and blamed for everything (Pushkin, 348). This again evokes the saintly images created by Karamzin and Griboyedov. Particularly similar to the young queen is Lisaveta in the following passage: â€Å"She had a fixed salary, but it was never paid in full; at the same time she was expected to dress like everyone else, that is, like the few. In society she played the most pitiable role. Everybody knew her, but nobody took any notice of her; at the balls she danced only when an extra partner was needed for a vis-à  -vis.† (Pushkin, 349) This image is similar to that of Elizabeth in that she had royal blood and for this reason was expected to dress and act a certain way; however she was not accepted by the society she was a part of. In addition to the way in which the young Elizabeth fit into society, Lisaveta is also similar to Elizabeth in her later age. When Elizabeth I was growing old she began having complications with her health that caused dizzy spells. She grew increasingly depressed and disallowed the word ‘death’ to be spoken in her presence (Antonov, 109). This antic can also be seen in the actions of Lizaveta in her interactions with Tomskii: â€Å"By the way, methinks she must be getting on, Princess Daria Petrovna? â€Å" What do you mean getting on?† Tomskii answered absentmindedly. â€Å"She’s been dead for these seven years.† The young lady raised her head and signaled to him. He remembered the old Countess was never informed of the death of any of her contemporaries, and he bit his lip.† (Pushkin, 345). In this instance the image of Elizabeth I gets somewhat muddled since it is unclear whether the countess disallows the subject of death to be brought up in front of her or if it is Lisaveta who does not like the idea. The old Countess herself mirrors Elizabeth I in that she cares a great deal about her outer appearance as the countess dressed in a fashion, â€Å"strictly following the fashions of the 1770s, spending just as much time on and paying just as much attention to, her toilette as she had sixty years before† (Pushking, 345). In similar fashion, Elizabeth I in her older age, had a monstrous collection of clothing, having owned 15,000 dresses and would change outfits two to six times a day (sAntonov, 107). Like the young Elizabeth and Lisaveta, the countess did not quite fit into the society she was a part of, â€Å"she participated in all the trivial events of high society life, dragging herself to balls, where she would sit in a corner, †¦the guests, as they arrived, would go up to her bowing low†¦but afterwards would pay no attention to her† (Pushikin, 348). If the relationship between Lisaveta and the Countess is further explored their dynamic can be seen as the countess being an old Elizabeth I and Lisaveta being the young Elizabeth I. Pushkin plays tricks on the reader with the images of Lisaveta and the countess. Perhaps the most striking example of this is that when Hermann is leaving the old Countess’s house and he, â€Å"pressed her cold, unresponsive hand, kissed her bowed head, and went out† (Pushkin, 362). It is not transparent here whether Hermann had just kissed the Lisaveta or the dead countess, which could be done by Pushkin on purpose. Perhaps the reason for the two Elizabeth-like characters is so that the old one can have the young one avoid marrying a person of above or of her own class and instead marry down. This is because the marriage of the countess is what brings the countess the cursed secret she has to keep since the old count refused to pay her debts and she had to seek outside help(Pushkin, 342). For this reason, when the apparition of the old countess comes to Hermann, she tells him, â€Å"I will forgive you my death under the condition that you marry my ward, Lizaveta Ivanovna†¦Ã¢â‚¬  (Pushkin, 365) and so the Elizabeth I image is put forth by Lizaveta. The final image of the Liza character appears in Gogol’s Dead Souls, in the form of Manilov’s wife Lizenka. Here the Elizabeth character is portrayed in a sickeningly sweet form. The relationship between Manilov and his wife are described as constantly feeding one another little tid-bits and candies. In the Lizenka character, Gogol is ultimately poking fun at the sentimentalist nature of the Liza character which can be contrived from Elizabeth I’s own character. Gogol does not take Karmzin’s sentimentalist writing as true literature and for this reason names Karamzin in the following instance: â€Å"Nor were his colleauges a wit inferior to him in enlightenment. For instance, one of them made regular practice of reading Karamzin, another of conning the Moscow Gazette, and the third of never looking at a book at all.† (Gogol, 142) Here Gogol takes on a sarcastic tone in describing the â€Å"great works† that the collegues indulge in. For this reason, Gogol choice of the diminutive form of Elizabeth, Lizenka is further support that her character her sweetie pie character is a parody to Karamzin’s Liza. This play on the the Liza character can be seen as a commentary on, Elizabeth I’s character as she was described as â€Å"kind and warm-hearted for the emotions sake alone† (Rice, 135). Gogol sees this type of personality as unintelligent and makes fun of Lizenka’s schooling which is somewhat similar to Elizabeth I’s in that Lizenka only learned French, the piano, and housewifery (Gogol, 22). However, regardless of her schooling, Lizenka through her relationship with Manilov is in charge of the souls which is perhaps a view he takes on Elizabeth I’s rule of the Russian people. By tracing the character traits and life events of Elizabeth I of Russia in Russian Literature following her rule, the emergence of the heroine Liza becomes evident. Beginning with Karamzin who evokes many of the holy and pure images that surround Elizabeth I’s and as well as Gribodev who shows the virginal beauty of the empress in his writing. Their literature is then followed by Pushkin, who focuses more on the outcast member of society that Elizabeth I was growing up under her Cousin Anne’s rule. And so the Liza character, heroine of Russian literature is created in celebration to Elizabeth I only to be ridiculed by Gogol in his brief apostrophes to Karamzin’s original work. So Liza’s character becomes an enigma in Russian literature history in that it is unclear whether her name is ultimately venerated or ridiculed in the minds of the readers of these great works. Works Cited Antonov, B. I., and Kenneth MacInnes. Russian Tsars: [the Rurikids, the Romanovs. St. Petersburg: Ivan Fedorov, 2005. Print. Coughlan, Robert. Elizabeth and Catherine: Empresses of All the Russias. London: Macdonald and Jane’s, 1975. Print. GogolÊ ¹, NikolaÄ ­ VasilÊ ¹evich, Constance Garnett, and Clifford Odets. Dead Souls. New York: Modern Library, 1936. Print. Griboyedov, Aleksandr Sergeyevich. Aleksandr Griboedov’s Woe from Wit: A Commentary and Translation. Lewiston, NY: Edwin Mellen, 2005. Print. Karamzin, NikolaÄ ­ MikhaÄ ­lovich, and Henry M. Nebel. Selected Prose of N.M. Karamzin. Evanston: Northwestern UP, 1969. Print. Krymow, Vincenzina. Mary’s Flowers: Gardens, Legends & Meditations. Cincinnati, OH: St. Anthony Messenger, 1999. Print. Pushkin, Aleksandr Sergeevich, and Paul Debreczeny. The Captain’s Daughter and Other Stories. London: David Campbell, 1992. Print. Rice, Tamara Talbot. Elizabeth, Empress of Russia. New York: Praeger, 1970. Print.

Essay on Napoleons Failure to Dominate Europe - 837 Words

Napoleons Failure to Dominate Europe A rulers reputation comes from the change that he inflicts upon his subjects, territory, and surrounding lands. Napoleon Bonaparte rose into power during the French Revolution, causing drastic changes not only to France, but to the rest of Europe as well. His domestic and foreign policies were not always successful, but his ability to rule was undeniable. From his rising in power and reform of France, up until his military defeat in Russia, Napoleon succeeded in gaining a considerate amount of power and control. In France, Napoleon used his power to make many reforms in all aspects of life. He incorporated a national bank, public schools, and constructed new roads. With these changes, he also†¦show more content†¦Also, the Civil Code limited some of the rights of women. Divorce was made more difficult for them, and after marriage, the husband had control of their property. In lawsuits, they were treated as minors, and their testimony was regarded as less reliable than that of men. (World History 641) Also, there were limitations on personal freedom such as press censorship, the use of spies, and the imprisonment of extremists. (Modern Times 58) In his domestic policies†¦Napoleon both destroyed and preserved aspects of the revolution. Even so, it appears that for the time being, Napoleon kept the people fairly well satisfied. (Modern Times 58) Napoleon accomplished much during his era. The name Napoleon recalls to mind great battles won, mighty countries humbled, and the near establishment of a union of all Europe under the supreme leadership of Napoleonic France. (Modern Times 59) But as others had discovered before him†¦no nation can rule Europe for long. (The World in 1800 p89) Later came his ultimate downfall- the Russian Campaign in 1812. While the Continental System was enforced, Russia was an ally of France, so Napoleon expected Russia to support the anti-British blockade policy. (Modern Times 62) Later, when he found that Alexander I of Russia opened Russian ports to British commerce, (Modern Times 65) Napoleon wanted to punish him because other countries might follow Russias act.Show MoreRelatedNAPOLEON’S INFLUENCE ON MODERN WESTERN MILITARY ARMIES Essay1867 Words   |  8 PagesNAPOLEON’S INFLUENCE ON MODERN WESTERN MILITARY ARMIES History 100, Staff Group A, CGSC Class 14-001 27 March 2014 1 Throughout history, military leaders have immortalized their legacies by vanquishing their enemies in the battlefield against overwhelming odds. Soldiers and historians have revered their accomplishments by studying their mastery in the art of warfare with the hopes mimicking their accomplishments. 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