PICOT Statement

PICOT Statement

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process. Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.
In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.
Describe the problem in the PICOT question as it relates to the following:
Evidence-based solution
Nursing intervention
Patient care
Health care agency
Nursing practice

PICOT Question
Now that you have chosen your topic for your research project, you will need to determine the path with which you will take to explore the clinical issue or problem. The PICOT question is the “blueprint” that will identify each element of your project and how you will find the measured outcome of the project. In this manner, you will build the framework of your capstone project change proposal.
The PICOT question will determine the population of which the identified clinical issue will be changed for improved patient outcomes. The initial intervention is the nursing practice change that you will introduce to your population. The comparison intervention is the current nursing practice that must be changed. The ultimate result of this change will be stated as the intended outcome of your project. The time frame of your project will be 10-weeks for our purposes as the class is only 10-weeks. {Normally you would want the first phase of a research project to be done over a 3-month time period. Then the analyzed gathered data is evaluated to determine the effectiveness of the nursing practice change. If is it effective, the change will stay in place. If it is not effective, the source of the ineffectiveness is determined, and the intervention is changed to be tested for another 3-months.}
Once your PICOT question is formulated and stated, you will discuss it in the areas below.
Evidence-based solution- look at the intended outcome. Are there references that support your outcome? Look at the 8 studies that were used in the week 2 assignment. Do any of these studies give you valuable evidence that can be related to your topic and the intended result of your project? If so, state how this study supports the topic.
Nursing intervention- the intervention is the nursing practice change that you want to implement which will improve patient care and outcomes. Explain the current nursing practice that should be changed and why it should be changed. Then state how the practice change will improve this situation.
Patient care- who is the patient population of your project? How will they be positively affected by the nursing practice change and why?
Health care agency- Describe the health care agency in which you are performing your practicum. What is the size of the facility, the type of patient’s cared for on the nursing unit and how many patients are cared for at any given time on this nursing unit.
Nursing practice- What is the current nursing practice? What is the problem that is caused by the clinical issue which you feel needs to be changed? How will the new practice change fix the practice problem?
Make your statements concise and use as few words as possible. Keep the word range in mind when you are writing your paper. Do grammar and spell check before submitting the paper.

CAPSTONE CHANGE PROJECT OBJECTIVES – No word range – Keep it to one page.
Your research project topic should be a clinical issue or problem that is taken directly from the care which is given to the individuals in the patient population. A cultural assessment that was done in week 2 with your preceptor will give you data with which you can connect your topic to your intervention. It is this connection which will lead to the list of 3 to 5 objectives for the proposed intervention.
State your population and the assessment of the patient culture on your practicum unit. Then determine how your nursing practice intervention should be created in the form of the objectives.
State the objective of the proposed intervention of your project. Then give a 1- to-2 sentence rationale for each objective.

After writing your 3-5 objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations in a clear and concise paragraph.
There is no word range count for this assignment. It is meant to prepare you for a section in your final paper on Week 8. Do a grammar and spell check prior to submitting your assignment.

PICOT Statement Paper

Hospital-acquired infections affect many patient populations, with a considerable impact on the quality of healthcare outcomes. Healthcare workers and patients hospitalized within the intensive critical care units are significantly exposed to the risk of hospital-acquired infections with a high number of mortalities across the world. According to Bezerra et al. (2020), handwashing hygiene is considered an effective strategy and approach in preventing hospital-acquired infections among healthcare workers and patients in the critical care units. Thus, the paper explores the relevance of embracing handwashing hygiene among the healthcare workers and adult patient population hospitalized in the critical care units for ten weeks.
PICOT Statement
In the adult inpatient critical care unit, what is the impact of the handwashing protocols and initiatives in reducing hospital-acquired infections among healthcare workers compared to those who fail to adopt handwashing hygiene practices for ten weeks?
The PICOT question provides an insight in assessing and evaluating the impact of adopting handwashing practice and protocols across the healthcare institution on the reported rates of hospital-acquired infections. Through the PICOT statement, it is possible to establish evidence-based practice regarding the impact of the initiative compared to a different patient population group that did not receive the intervention to make informed decisions regarding its effectiveness in the nursing practice.
Evidence-Based Solution
The PICOT question will be solved by implementing handwashing protocols and practices within the adult intensive care units for health workers and patients to reduce the prevalence of hospital-acquired infections. Healthcare institutions need to adopt appropriate handwashing hygiene and monitoring systems to enhance compliance with the protocols in realizing considerable impacts on reduced hospital-acquired infections (Haque et al., 2020). In future nursing practice, it would be critical to encouraging healthcare workers within the adult intensive care units to adopt handwashing protocols and strategies to mitigate the risk of disease transmission across the populations.
Nursing Intervention
Handwashing protocols and hygiene strategies are interventions that would be implemented to improve the nursing situation. While considering over 99,000 deaths arise due to hospital-acquired infections across the hospital-acquired infections, it is notable that handwashing hygiene practices provide a proactive approach in reducing the vulnerability of inpatient populations receiving critical care (Hessels & Larson, 2016). In determining the interventions’ effectiveness, the comparison would involve the assessment of intensive care units with normal operations with no attribution to the use of handwashing techniques.
Patient Care
The adult patient population receiving intensive care often experience immunocompromised conditions with a relatively higher risk of hospital-acquired or nosocomial infections. According to Malliarou (2017), the handwashing protocols and initiatives focus on improving sanitation practices in eliminating the potential for contaminating equipment while attending to patient populations. Handwashing hygiene practices would reduce infections among healthcare professionals and patients in intensive care units during their interactions.

Health Care Agency
The practicum will be conducted in a healthcare institution that offers adult intensive nursing care for patients with diverse complications. The comparison of the results will focus on healthcare institutions that undertake standard practices across various healthcare institutions in Greenfield city in Milwaukie in the United States.
Nursing Practice
Handwashing protocols and practices would reduce pathogenic transmission rates for patient populations and, consequently, ensure the nursing professionals improve their focus on the underlying patient conditions (Malliarou, 2017). Thus, the handwashing practice would reduce the incidences of illnesses among nursing care workers, thereby enhancing the overall patient care and health outcomes.
Conclusion
Hospital-acquired infections negatively impact nursing care and health outcomes. Adult patients in the critical care units and nurses are at greater risk of acquiring hospital-acquired infections. The practicum would focus on implementing handwashing practices for nurses and patient in the adult critical care unit while comparing them with those undertaking everyday hygiene practices over ten weeks. While considering evidence-based practice, handwashing is an important initiative for reducing nurses and patient populations’ vulnerability. As such, it is critical to assess its influence in promoting its adoption in healthcare institutions.

References
Bezerra, T. B., Valim, M. D., Bortolini, J., Ribeiro, R. P., Marcon, S. R., & Moura, M. E. (2020). Adherence to hand hygiene in critical sectors: Can we go on like this? Journal of Clinical Nursing, 29(13-14), 2691-2698. https://doi.org/10.1111/jocn.15293
Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to prevent healthcare-associated infections: A narrative overview. Risk Management and Healthcare Policy, 13, 1765-1780. https://doi.org/10.2147/rmhp.s269315
Hessels, A., & Larson, E. (2016). Relationship between patient safety climate and standard precaution adherence: A systematic review of the literature. Journal of Hospital Infection, 92(4), 349-362. https://doi.org/10.1016/j.jhin.2015.08.023
Malliarou, M. (2017). Hand hygiene of nurses and patient safety. International Journal of Nursing & Clinical Practices, 4(1). https://doi.org/10.15344/2394

 

GOSPEL CHRISTOLOGY

GOSPEL CHRISTOLOGY

The Gospels have been described as “biographical sermons” of Jesus. They are biographies in that they aim to inform the audience (whether reading or hearing) about the life and legacy of the protagonist – Jesus of Nazareth. They are sermons in that they aim not merely to inform, but to inspire, persuade, and elicit a response. Where multiple sources of the same presentation exist, inevitably those presentations are both alike and different. Think “remake.” For example, the movie, True Grit, was originally released in 1969 with John Wayne as “Rooster” Cogburn. It was remade in 2010 with Jeff Bridges as “Rooster” Cogburn.” The story is essentially the same in both movies, but the way the story is interpreted in the two movies, and the way the central character, “Rooster” Cogburn, is portrayed, is different. That is because the directors of the two movies paint a portrait of the central character, “Rooster” Cogburn,” so that the audiences see him through the directors’, or storytellers’, eyes. In much the same way, the four Gospel writers tell the same story of the central character of their biography, Jesus of Nazareth; but because we see Jesus through each Gospel writer’s eyes, we see a unique portrait of him in each of the four Gospels. In scholarly parlance, we call this “portrait” of Jesus the Gospel’s Christology; that is, its understanding, and presentation, of Jesus the Christ.

 

Christological Mark of Jesus as Son of God.

Christological Mark of Jesus as Son of God.

The Gospels have been described as “biographical sermons” of Jesus. They are biographies in that they aim to inform the audience (whether reading or hearing) about the life and legacy of the protagonist – Jesus of Nazareth. They are sermons in that they aim not merely to inform, but to inspire, persuade, and elicit a response. Where multiple sources of the same presentation exist, inevitably those presentations are both alike and different. Think “remake.” For example, the movie, True Grit, was originally released in 1969 with John Wayne as “Rooster” Cogburn. It was remade in 2010 with Jeff Bridges as “Rooster” Cogburn.” The story is essentially the same in both movies, but the way the story is interpreted in the two movies, and the way the central character, “Rooster” Cogburn, is portrayed, is different. That is because the directors of the two movies paint a portrait of the central character, “Rooster” Cogburn,” so that the audiences see him through the directors’, or storytellers’, eyes. In much the same way, the four Gospel writers tell the same story of the central character of their biography, Jesus of Nazareth; but because we see Jesus through each Gospel writer’s eyes, we see a unique portrait of him in each of the four Gospels. In scholarly parlance, we call this “portrait” of Jesus the Gospel’s Christology; that is, its understanding, and presentation, of Jesus the Christ.
Contents

Introduction

Thesis statement

Context of Mark’s gospel

Jesus as Son of God

Mark’s Christology according to Scholars

Conclusion

Bibliography

Introduction

According to the Bible in the New Testament, Jesus has many names indicating his numerous responsibilities and prowess through the divine power conferred from God the Father. The Gospel of Mark portrays Jesus as an important being while highlighting his limited roles to humans across the world. According to Mark, the Gospel points to the diverse nature of Jesus as the Son of Man, God’s son, and a Teacher. Through his understanding and perception of Jesus, Mark recounts the aspects of his numerous responsibilities during his encounters with his disciples, Pharisees, and congregations. Mark expresses and continuously reminds his audience of God’s religious message brought to human beings by Jesus Christ. Besides, Mark portrays Jesus as an important figure in human beings’ lives and to the world carrying the righteous message from our creator, God. For instance, in Mark 1:8, the message points to his role in undertaking baptism through the Holy Spirit[1]. Throughout the Gospel of Mark, the nature of Jesus is portrayed as part of the overarching message and explanation of his role and nature to human beings. In general, Mark tends to provide a critical perspective of Jesus as the Messiah and his crucifixion despite being the God’s son.

Additionally, Mark’s Christological assertions of Jesus provide a broader approach to the underlying role of Jesus Christ in the world. Through the introduction, Mark’s Gospel provides an in-depth assessment of the ministry of Jesus while setting the overview of Jesus’ baptism by John the Baptist. Mark points to John’s message regarding the repentance message, baptism, and temptation. Mark’s messages set the stage for expressing Jesus as the God’s son while reaffirming his role as part of the trinity with divine power bestowed to him from God the Father. The chronological timeline in the affirmation of Jesus’ role provides the basis for determining his relationship with God, the creator. Jesus’ teachings, parables, healings, and miracles illustrate the direct relationship with God. Besides, the affirmation through God’s words and Jesus’ pronouncement through the Old and New Testaments provides the basis for enhancing an understanding of Jesus as God’s son. Mark’s portrayal of Jesus through his works provides a basis for endorsing Jesus as God’s son. Moreover, throughout his writings of the Gospel, Mark ensures that his actors and speakers utilize specific words that exemplify the Christological representation of Jesus. While highlighting the unwritten events and dimensions of Jesus, Mark displays critical accounts that emphasize the direct association of Jesus as the God’s son.

Thesis statement

The Christological aspects outlined the Gospel of Mark convey Jesus as the Messiah and as the God’s son in his works, teachings, and life history. The interconnection between Jesus as a God’s chosen son reaffirms the Christian knowledge in deriving his power and authority. While Mark utilizes different situations to heighten the role of Jesus in salvation, teacher, healer, and sufferer, his role as the son of God provides Mar’s introduction. The Bible, through different contexts, also supports Mark’s declaration of Jesus as God’s son. There is authoritative proof in Jesus as God’s son and Him as the Father by determining diverse literary evidence from various scholars. The paper highlights the Christological perspective of Gospel of Mark relating to Jesus, the God’s son. Besides, the paper expresses the assertions from different authors regarding Mark’s Christological image of Jesus as God’s son. The paper provides a comprehensive analysis and insight into the nature of Jesus and God with their direct relationship involving Son and Father, respectively, in their nature.

Context of Mark’s Gospel

Mark was one of Jesus’ disciples and evangelists who were considered to have witnessed Jesus’ actions during his existence during the early days. Besides, it is presumed that Mark’s Gospel was written in Rome due to its relationship and proximity to Christ’s teaching, with Mark traveling from Rome to Jerusalem, impacting the early Christians’ faith during the past. According to Mark, in the last chapters in the Gospel, the mention of different cities and towns across the region close to Rome illustrates his theological work’s critical role and nature in the early days[2]. The Gospel, according to Mark, is considered to highlight the authority bestowed on Jesus from God. In most instances, Mark refers to Jesus as the God’s rightful son while he refers himself to the Man’s son. Compared to other gospels, Mark’s Christology is considered low on God’s divine being while only asserting the power in undertaking various miracles and accomplishing the mission according to the heavenly requirements. Peter may have inspired Mark due to their close relationship and interaction. For instance, Peter highlights his greetings from Babylon and Mark, whom he considers his son (1Pet. 5:13)[3]. In this context, Peter refers to Mark as his son, which evidences their association in learning and exploring the Gospel of the Messiah and God according to the divine nature. Besides, early Christians suppose Peter’s role in Mark’s life by influencing his Christology in affirming the role of Jesus in human beings’ lives while witnessing his actions in the world.

Moreover, while considered the earliest crafted Christ’s teaching, the Gospel according to Mark is considered to emphasize Jesus’s actions, the aspects of the irony and theological discourses that provide a basis for developing an understanding of Jesus’ nature relating to his relationship with God. The Gospel is written in the form of a story with the first chapters denoting Jesus’ ministry on earth while reaffirming the Messiah’s diverse perspectives and God’s son. Mark’s Gospel encompasses the past and future, providing critical teachings to the Christian life with the direct connection asserting the role of Jesus as God’s son. For instance, Mark is quoted highlighting his role in preparing for us a place in heaven. Within the context, Mark considers Jesus as the doer of God’s work while assuring human beings in his role in the second coming as the great Messiah. Mark’s Gospel portrays the role of Jesus as God’s servant, who came to the world to accomplish His desire for the human race’s salvation. As such, Mark provides critical insight into the ascension of Jesus Christ as the Son of God by pointing his role as God’s servant, thereby reassuring God’s presence to the world through his only son, Jesus Christ. Despite different gospels expressing the genealogy of Jesus, Mark’s Gospel focuses on developing a critical understanding of his relationship with God. Thus, Mark’s context expresses the role of Jesus in the world as God’s son and messenger, heightening the close call for abiding by his teachings for Christians.

Jesus as Son of God

The Gospel, as pointed out by Mark, highlights different contexts and themes that enhance the understanding of the role of Christ. Nonetheless, the assertion of Jesus as the Son of God is predominantly evident across different chapters and verses in Mark’s book. In the first verse, Mark begins by highlighting the foundation of the good news brought to the world through the God’s son (Mark 1:1)[4]. The context of Mark’s beginning emphasizes the direct connection to God, reciting Him as the Father and Jesus as His workman in spreading the true Gospel of God. While in different instances, Jesus is referred to as a prophet, Mark describes Jesus as God’s rightful son who had the authority bestowed to him in bringing the good news and Gospel to the world.

Additionally, the verse affirms the anointing of Jesus is representing God in highlighting the Gospel critical for the salvation of humanity. Mark refers to Jesus as the Christ while also illustrating his role as the Son of God. Mark considers Jesus to have come from the Father, thereby heightening their relationship. As such, Mark’s Gospel affirms that Jesus was the special Messiah and God’s chosen son with the divine authority from God the Father[5].

Again, Mark features Jesus as God’s son during his baptism, in which he noted a voice pointing to the voice of God. Mark notes that the voice affirmed Jesus as God’s son with who God was pleased with relating to his actions (Mark 1:11)[6]. The baptism of Jesus represented a unique event that was marred by heavenly surprise. Christ’s baptism represented his first-ever appearance which denoted the special perspective to the ever-known aspects of Jesus. The baptism involved a noteworthy course in which God confirmed to the world and Christian believers of His relationship to Jesus whom he had sent to rescue a part of the course of salvation. God attempted to manifest Himself through the great power he possessed regarding His relationship to Jesus as His son[7]. In the verse, Mark notes that God testifies to the greatness of Jesus as his son and his actions during his stay on earth. The affiliation of God enhances a critical understanding of his association with Jesus Christ[8]. He constantly endeavored to remain affiliated during his course of salvation for the human race. As such, God’s direct words to those present during Jesus’ baptism endeavored to confirm their previous knowledge and awareness of Jesus as God’s son, possessing might, power and authority in his actions.

Additionally, Jesus, as God’s son, is manifested through Mark’s insights into Jesus’ exorcism. The incidence in which Jesus drives away the evil spirits points to the eschatological exorcism and nature of Jesus through the perspectives of the evil spirits (Mark 1:24)[9]. From the scripture, the evil spirits respond by asking what Jesus of Nazareth had to do with their stay while further referring to Jesus as the Holy One of God. The devil and spirits act contrary to the requirements of the Holy Spirit. The Bible, throughout many scriptures, refers to Jesus as God’s son. In the scripture, the evil spirits reiterate Jesus as the Holy One from God. In this instance, Jesus’ relationship with God is evident as there is no other being that has a direct relationship and engagement to that of either God or Jesus Christ. The messianic application of the words, Holy One, denotes that Jesus was the preferred individual whom God had sent to the world to bring upon his message (Mark 5:1-20)[10]. Also, only Jesus had the capacity and authority to undertake God’s intended actions as part of his approach to accomplishing his desired redemption and deliverance to humankind. Through exorcism, the evil spirits manifest their knowledge and appreciation as the Son of God, further echoing their innate relationship.

The evangelical aspects and summary in which Jesus came in contact with the evil spirits further amplify his Christological affiliation as the Son of God. Chapter three of Mark points to the diverse reactions from the individuals with Jesus over various instances. For instance, the evangelical perspective points to the unclean spirits referring to Jesus as the Son of God. The appreciation of the unclean spirits and their conviction of Jesus’ mighty power enhance the realization of the connotation of Jesus as the only true Son of God. The evil spirits are compelled to refer to Jesus as Son of God while affirming his control and influence over the earth and its creatures. Through the scripture, Mark highlights God’s focus in reigniting the Christological emphasis on God’s Son. Jesus is noted to possess supreme power similar to God’s power that the unclean spirits and devils appreciate as they emanate from God, the creator. In the same manner that Jesus discerns the evil spirits, they also discern him as the true son of God with the appropriate reverence to his authority over their demonic powers. Therefore, Mark’s concept provides reassurance to Jesus in his relationship as the Son of God.

Further, during Jesus’ trial, Mark points to Jesus’ affirmation as the Son to God. When the High Priest asks Jesus if he has anything to answer, and later the son of God, Jesus accepts connotation. Jesus espouses his responsibility during the end of the world as the only person who will sits on the right-hand side of God on His throne (Mark 14:60-62)[11]. The assertions illustrate Mark’s Christological affirmation of Jesus as God’s son. Besides, as highlighted by Mark, the transfiguration of Jesus upholds the Christological perspective of Jesus as God’s son. During the period in which the cloud overshadows the period, a voice says, “This is my Son, my beloved, listen to Him” (Mark 9:7)[12]. The voice exemplifies God’s protection and continuous pride in affiliating with Jesus as His treasured son despite all the humiliations and suffering he experienced on earth. Throughout the incidences, Mark provides a vivid illustration of the various relationships between Jesus and God. God upholds Jesus as his son throughout his suffering while providing reassurance of His presence during all the circumstances Jesus faces despite the challenges he experiences. Thus, through Mark’s perception, the Gospel enhances the understanding of Jesus as the Son of God, whose role was divine throughout his ministry and life on earth.

Mark’s Christology according to Scholars

Many scholars have expressed Mark’s Gospel while associating it with Paul’s influence in expressing the reaffirmation of Jesus as God’s son. According to Igbari, the exorcist aspects of Jesus have provided a rationale for recognizing Jesus’ importance in Christianity today[13]. The author points to Mark’s experience during Jesus’ exorcist in promoting Christian practice and approach towards enhancing prayer and rebuking the devil’s power and unclean spirits in the current society. Through the author, Mark’s Christology integrates different concepts in evaluating the relationship between Jesus and God as the Father and Son, respectively. Thus, the scholar explores an elaborate experience according to Mark and the Gospel, heightening his Christological nature of Jesus’ teachings.

Additionally, Johansson points to Mark’s view of Jesus through the divine form asserting to Jesus supernatural and metaphysical sense[14]. While criticizing the theocratic sense enhanced by previous authors on the position of Jesus, the author points to Jesus as the Son of God while proclaiming his experiences to generate a direct link and understand their inseparable relationship. The author expresses the role of Jesus as an eschatological preacher whose message was from God his Father. As such, the authors relate to Mark’s Christological perspectives on Jesus as God’s son.

Elsewhere, Yencich provides a critical commentary and insight into Mark’s Christological perspective of God as the Father and Jesus as His son[15]. The authors point to the instance where the devils still give reverence to Jesus as the son of God despite his suffering and humiliation. Mark provides an imperative aspect of Jesus’ experience and encounters while pointing to God’s reassertion of His control over His son Jesus Christ. The confessions enhance a critical insight into the association between Jesus and God in the fatherly relationship. Bauckham also confirms Mark’s exposition of Jesus as the son of God through his divine response that continues to give God devotion as the Father[16]. For instance, the story of Jesus Trial and crucifixion provides an elaborate aspect of Jesus responding as the son of God by claiming that I am (Mark 14:60-63)[17]. The author, concerning other writers’ works back Mark’s Christological viewpoint on Jesus as God’s son. While confirming Jesus through distinct perspective, Bauckham enhances the understanding of the divine nature and relationship with God following Mark’s Gospel in the Bible[18].

Besides, Wiryadinata endorses Mark’s Christological perspective on Jesus as the Son of God[19]. The author makes a critical comparison to the role of Jesus on earth through the Son of Man and Son of God’s lens. Despite the naming differences, Wiryadinata supports the Christology of Jesus as the son of God who came in the human form. The evidence enhances the underlying notion of Jesus’ role sent to humans from God the Father. The assertion of Jesus narrative outcome points to his power and authority over the entire universe with the legions

begging him to spare them in the name of Jesus (Mark 5:13-14).[20]

More, Mark’s Gospel initiates the Messianic Gospel with the good news to the world through Jesus, the son of God. In the commentary about Mark’s Gospel, Schnabel provides an intuitive description of Jesus as the son of God through his chronological aspects of events that result in his crucifixion and death on the cross for the human race. Through Schnabel’s commentary, it is evident the authors confirm the true identity of Jesus the savior as the only Beloved Son of God, evident from different scriptures in Mark’s Gospel. While pointing to the crucifixion of Jesus, the author enhances a clear description of God’s Son, Jesus, who offered salvation as sent from the Father. The context is similar to that in Mark’s Gospel in which a voice is heard, distinguishing Jesus as truly the son of God (Mark 15:39)[21].

Conclusion

The Gospel of Mark provides a clear illustration of his experiences and attribution to the influence of Paul in writing his works. Throughout the Gospel, Mark elucidates the identity of Jesus through his experiences and diverse contexts relatable to other gospel writings in the Bible. While Mark’s inspiration highlights different titles of Jesus including Teacher, Healer, Christ, the Anointed One, Son of Man, Son of David, and Jesus of Nazareth, the Christology of the Son of God is a prominent ideological underpinning of his teachings. Mark’s Christological illustration of Jesus indeed approves of his identity as the true son of God. The numerous instances in which a voice is heard from heaven and Jesus confirms his identity indicate his Father, God’s direct link. With the numerous scholars attributing the identity of Jesus to the son of God in their literary works, their declarations support Mark’s perspective and approach to highlighting the concept of Jesus the Son and God the Father in a hierarchical relationship. While the term son of man contrasts his identity resulting in his suffering and afflictions, the works heighten his eschatological teachings regarding his unique personality and origin as God’s son. Throughout his miracles, the enthronement of Jesus, teachings, and healing works ascertain his distinctiveness and role in spreading the gospel works. Therefore, Mark provides a chronological nature of events that express and verify Jesus’ true identity across the human race.

 

Bibliography

Bauckham, Richard. “Markan Christology according to Richard Hays: Some Addenda.” Journal of Theological Interpretation 11, no. 1 (2017): 21-36.

Igbari, O. “Exorcism in Mark’s gospel: Implications of Jesus’ perspective for today.” Studies in Asian Social Science 5, no. 1 (2018), 40.

Johansson, Daniel. The Identity of Jesus in the Gospel of Mark: Past and Present Proposals”. Currents in Biblical Research 9, no. 3 *2010): 364–393

Schnabel, Eckhard J. Mark. InterVarsity Press, 2017.

The New King James Version (NKJV). Retrieved from: https://www.kingjamesbibleonline.org/

Wiryadinata, Halim. “The son of man: “Is it constructive theology and history of Jesus for the New Testament writing?”.” PASCA: Jurnal Teologi dan Pendidikan Agama Kristen 16, no. 2 (2020): 94-102.

Yencich, Danny. “The Centurion, Son of God, and Georgia Board of Pardons and Paroles: Contesting narrative and commemoration with Mark.” Horizons in biblical theology 39, no. 1 (2017): 1-15.

Botner, Max. Jesus Christ as the Son of David in the Gospel of Mark. Vol. 174. Cambridge University Press, 2019.

[1] The New King James Version (NKJV).

[2] Botner. Jesus Christ as the Son of David in the Gospel of Mark.

[3] The New King James Version (NKJV).

[4] The New King James Version (NKJV).

[5] Wiryadinata, Halim. “The son of man: “Is it constructive theology and history of Jesus for the New Testament writing?”.” PASCA: Jurnal Teologi dan Pendidikan Agama Kristen 16, no. 2 (2020): 94-102.

[6] The New King James Version (NKJV).

[7] Yencich, Danny. “The Centurion, Son of God, and Georgia Board of Pardons and Paroles: Contesting narrative and commemoration with Mark.” Horizons in biblical theology 39, no. 1 (2017): 1-15.

[8] Johansson, Daniel. The Identity of Jesus in the Gospel of Mark: Past and Present Proposals”. Currents in Biblical Research 9, no. 3 *2010): 364–393

[9] The New King James Version (NKJV).

[10] Ibid

[11] The New King James Version (NKJV). Retrieved from: https://www.kingjamesbibleonline.org/

[12] Igbari, O. “Exorcism in Mark’s gospel: Implications of Jesus’ perspective for today.” Studies in Asian Social Science 5, no. 1 (2018), 40

[13] Igbari, O. “Exorcism in Mark’s gospel: Implications of Jesus’ perspective for today.” Studies in Asian Social Science 5, no. 1 (2018), 40.

[14] Johansson. The Identity of Jesus in the Gospel of Mark: Past and Present Proposals

[15] Yencich. “The Centurion, Son of God, and Georgia Board of Pardons and Paroles

[16] Bauckham. “Markan Christology according to Richard Hays

[17] The New King James Version (NKJV)

[18] Bauckham. “Markan Christology according to Richard Hays

[19] Wiryadinata. “The son of man: “Is it constructive theology and history of Jesus for the New Testament writing?

[20] The New King James Version (NKJV)

[21] The New King James Version (NKJV)

Self-Assessment of Program Learning Outcomes

Self-Assessment of Program Learning Outcomes

Self-Assessment

  • Identify the role of the professional nurse within the global healthcare delivery system
  • Use inter-and-intraprofessional communication and collaboration skills to optimize patient outcomes
  • Apply quality improvement methods to implement safety initiatives and patient outcomes effectively
Student Reflections:

As a professional nurse, I have endeavored to involve in the development and implementation of global health policies focused on improving patient care. While realizing the multiplicity of health issues, it has been possible to lobby for global health prioritization as a major concern through global health diplomacy. According to Reeves et al. (2017), inter-professional collaboration focusses on achieving great team performance as part of an approach towards achieving positive global health outcomes. Besides, I have focused on improving my approach to patient care to recognize the need to advance my communication and collaboration skills in enhancing positive health outcomes. My placement has offered an opportunity to establish a culture of safety and commitment to continuous improvement as a quality improvement method aimed at enhancing patient care.

 

 

·      Describe the impact historical nursing leaders have on the practice of nursing today

·      Describe the impact historical nursing leaders have on the practice of nursing today

·      Summarize the role expectations of the professional nurse

·      Examine the ethical and legal principles guiding professional nursing practice

·      Evaluate strategies to improve nursing care through synthesizing knowledge from nursing, humanities, sciences, and the arts as a basis for a personal philosophy of professional nursing

·      Apply quality improvement methods to implement safety initiatives and patient outcomes effectively

Student Reflections:

Historic nursing leaders have set the current nursing pace in advancing patients’ rights while pursuing evidence-based standard practices to achieve appropriate nursing care. As a professional nurse, I have focused on pursuing evidence-based practice, including upholding human dignity and patient’s integrity as part of the growing need for aligning with the previous theoretical underpinnings. Additionally, I have focused on advocating for implementing ethical principles and social justice as part of the overall goal of attaining positive global health outcomes. While recognizing the global need for sharing information in the nursing field, I have focused on developing a collaborative approach and framework to knowledge translation and implementing quality improvement programs across the healthcare environments.

 

Final Thoughts (Optional):

Student Reflections: Recommendations for further development/improvement, of course, to better meet these course and program outcomes.
Indeed, the course needs to embrace historical nursing practitioners’ specific involvement who greatly impacted the current nursing practice. Through the approach, it would be possible to improve one’s alignment with the specific nursing outcomes effectively.

 References

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviewshttps://doi.org/10.1002/14651858.cd000072.pub3

Develop Internally Consistent Job Structures for e-sonic

Develop Internally Consistent Job Structures for e-sonic

Develop Internally Consistent Job Structures for e-sonic

  1. Job Descriptions
  2. Office Manager

Job Summary

The office manager is responsible for the everyday activities of the Bureau by overseeing its smooth functioning and performance.

Responsibilities

  • Device monitoring, repair, and office equipment service
  • The mobile answer, direct calls, and texts.
  • management of filling processes, mailing systems, and libraries
  • The task of holding the budget of the Office
  • Production of plans and oversight of annual review administration.

Qualifications

  • College diploma required
  • The experience of handling an office environment
  1. Creative Director

Job Summary

The creative director plays an important part in the creative process by promoting others and securing the copy editors in all works (O*Net Online 2015).

Responsibilities

  • provides creative assistance to advertising-related copywriters with response
  • Copywriters management
  • Welcomes and helps copy authors with controlled topics and presentations
  • Establish planning, delegate roles, and organize the management of annual assessments.

Requirements

  • Certificate of high school is mandatory
  • A degree in the area of communications, advertisement, and innovation
  • Requires four years of technical or musical production experience.
  • Director of Customer Service

Summary

The customer service director is responsible for supervising and managing all staff engaged in customer service programs (O*Net Online, 2015). Often, serious problems in the company will also be dealt with.

Responsibilities

  • All staff in the role of customer care •
  • Provides staff with consumer action settlement templates
  • Scheduling of calendars, assigning of assignments, and organization of annual reviews
  • Development and execution, with the assistance of the board, management and support personnel, and human resources officers of strategy, priorities, instructional programs, and processes;
  • Organizing sales marketing exercises while supervising practice and management of other corporate units.

Requirements

  • Certificate of high school is mandatory
  • Graduate in a similar business area or nine years’ customer services industry experience
  • Minimum five years of customer service business experience
  • A minimum of four years of experience as a general analyst or even a superior role and detailed instruction in dispute resolution matters
  • Customer care capability Efficient.
  1. Artist Relationship Manager

Job Summary

To establish new partnerships with designers and production bodies, the creative partnership manager oversees. He or she can also retain existing artists and producing businesses (O*Net Online, 2015). The position of the royalties for registered artists and production companies for advantageous negotiations is also mandated.

Responsibilities

  • Establishing and sustaining reliable working relationships with musicians and production companies.
  • Supporting partnerships by using them to build and strengthen new relationships
  • Writing interesting news releases for musicians
  • Creation and management of the image and reputation of the company with artists and production companies
  • To assist external organizations in establishing and upgrading frameworks for contact and intelligence initiatives
  • Analyze and test ads for artist/production Company’s compatibility.

Requirements

  • A diploma is required for high school.
  • A minimum four-year business degree
  • Minimum five years of experience in market production in an area focused on technology or music.
  1. Job Structures

The next move will be to describe the systems after developing the work descriptions (Martocchio, 2015). The advisory committee agrees on the form and type of systems that are to be graded. The following table provides an example of different E-Sonic jobs and groups.

Administrative Sales and Marketing Development Consumer Service
Executive Assistant Marketing Director Director of Software Development Director of Consumer Service
Administrative Assistant Creative Director Software Project Manager Customer Service Manager
Office Manager Copy Writer Software Engineer Customer Service Agent I
Artist Relationship Manager Market Research Analyst Software Testing Customer Service Agent II

 

  1. Build Point Evaluation Method

The item approach applies to an appraisal of work content using a quantitative mechanism. In this context, the statistical approach tends to allocate reimbursable items that define jobs (Martocchio, 2015). The values are then summarized as a specific meaning indication of a work. This results in a ranking of their average total amount worth by the proportional value of the workers (Martocchio, 2015). The measures involved include selecting benchmarking work, selecting compensable components based on benchmarks, deciding the declaration of the variable degree, and defining the weight of each compensable dimension.

  1. a) Select benchmark jobs.
  2. Administrative
b) Compensable Factor c) Degree Statements d) Weights in Percentages
Administrative and Management Knowledge First Degree: Continue properly with documentation and documents

Second degree: Deal well with both management and logistical activities

Third degree: Handle new recruitment drives and entries

Fourth degree: Could check both accounts and financial reports

Fifth degree: Annual examination planning

30%
Computer Software Application Knowledge and Skill First Level: Computer program comprehension

Second Level: Should use the software for the machine

Third Level: Make software development suggestions

Fourth Level: Indulge in the real program installation

Fifth Level: Periodic review clause

15%
Writing and Attention to Detail Knowledge and Skills First grade: Write plain sentences and phrases

Second grade: Draft composite declarations and complex declarations

Third Grade: Reports and essays in draft

Fourth Grade: Build letters, summaries, and analyses for companies

Fifth Grade: Speech draft and news correspondence

15%
Oral and Written Skills Grade 1: To speak in plain language

Grade 2: Understanding and analysis of abstract statements

Grade 3: Produce published records

Grade 4: Company letters and presentations

Grade 5: Interact in meetings of the board

25%
Time Management Skills Grade 1: Successfully control time

Grade 2: Construct own task schedules

Grade 3: Creation of timetables for others

Grade 4: Time estimation done for tasks

Grade 5: Include timetable suggestions

15%
  1. Sales and Marketing
Compensable Factors Degree Statements Weights in Percentages
Marketing and Sales Knowledge Grade 1: marketing and distribution awareness

Grade 2: Worthy of recognizing campaign strategies

Grade 3: May draft strategies for marketing

Grade 4: Sales research is understandable

30%
Knowledge about Society Grade 1: Grasp the target culture

Grade 2: Understands nuanced social values

Grade 3: Will make social suggestions

Grade 4: Should consider consumers’ tastes and desires

Grade 5: May check social reporting

15%
Critical Thinking Skills Grade 1: Will build ideas

Grade 2: Will collaborate on new projects in teams

Grade 3: Will carry out new ideas

Grade 4: You appreciate how complicated problems can be solved

Grade 5: Logical thinking should be used to solve problems.

15%
Communication and Media Association Skills Grade 1: Capable of successfully transmitting and transmitting information

Grade 2: Media information can be read and translated quickly

Grade 3: Will build promotions

Grade 4: Can be readily correlated with media workers

Grade 5: Can interact through media

25%
Oral and Written Statement Capabilities Grade 1: Capable of oral and written correspondence.

Grade 2: Can read and understand comments in writing

Grade 3: Should chat publicly with faith

Grade 4: Will compose media efficiency of the engine

Grade 5: Capable of sending team reports

15%
  • Development
Compensable Factors Degree Statements Weights in Percentage
Engineering Knowledge Grade 1: Worthy of engineering concepts

Grade 2: Has technology experience

Grade 3: Applies technical principles to actual problems

Grade 4: Engineering creation can be expressed into processes

Grade 5: Apps should be built

30%
Decision Making Skills Grade 1: Can assist in general decision-making

Grade 2: Will present reliable choices

Grade 3: Worthy of collective decision-making

Grade 4: Can convince anyone easily?

Grade 5: May plan to take action

15%
Design Knowledge Grade 1: Detailed design

Grade 2: May parts evaluate design

Grade 3: May design graduation

Grade 4: Can be designed in processes

Grade 5: Should train designers

15%
Critical Thinking Skills Grade 1: Cognitive reasoning is applicable

Grade 2: One should consider solutions objectively

Grade 3: The best alternatives should be chosen

Grade 4: Solutions to complex problems

Grade 5: Proposals should be questioned

25%
Oral and Written Expression Abilities Grade 1: Capable of transmitting information

Grade 2: Worthy of convincing others

Grade 3: Capable of reading and writing difficult statements

Grade 4: Able to communicate through oral speech

Grade 5: Will create complicated reports

15%
  1. Consumer Service
Compensable Factors Degree Statements Weights in Percentages
Customer Service Knowledge Grade 1: Helping customers to understand

Grade 2: Consumer partnership

Grade 3: Delivers compelling consumer details

Grade 4: Includes the complexity of consumers

Grade 5: Market concerns resolution

30%
Computer Skills Grade 1: Capable of using a device

Grade 2: Should analyze computer market data

Grade 3: can work with productivity and speed

Grade 4: Complex applications that can be used

Grade 5: Can assist consumers in interpreting data quickly

15%
Critical Thinking Skills Grade 1: Market issues should be objectively thought of

Grade 2: Will create difficult solutions.

Grade 3: Will reason with clients

Grade 4: Can use solutions available

Grade 5: Novel remedies may be established

15%
Problem Solving Skills Grade 1: A problem solving comprehend

Grade 2: Alternatives from options are sought

Grade 3: Actively engaging in teams

Grade 4: Ideas should be applied

Grade 5: You should disclose problems

25%
Oral and Written Communication Skills Grade 1: Oral and written consumer correspondence

Grade 2: Interacting successfully with consumers

Grade 3: Capable of reading complicated declarations

Grade 4: Solutions to connect

Grade 5: Able of settling conflicts effectively

15%

 

  1. Calculate Point Values for e-Sonic Jobs

Administrative Job Structure

Compensable Factor Total
Degree 1 2 3 4 5
Administrative and Management Knowledge 90 175 260 335 460 180
Computer Software Application Knowledge and Skill 40 70 105 140 175 345
Writing and Attention to Detail Knowledge and Skills 40 70 105 140 175 275
Oral and Written Skills 55 120 180 240 300 350
Time Management Skills 40 65 95 135 160 275

 Total Points for Administrative Job Structure: 630

Sales and Marketing

Compensable Factor Total
Degree 1 2 3 4 5
Marketing and Sales Knowledge 85 170 255 340 425 85
Knowledge about Society 35 70 105 140 175 155
Critical Thinking Skills 35 70 105 140 175 155
Communication and Media Association Skills 60 120 180 240 300 205
Oral and Written Statement Capabilities 35 70 105 140 175 190

Total Points for Sales and Marketing Job Structure: 450

Development

Compensable Factor Total
Degree 1 2 3 4 5
Engineering Knowledge 85 170 255 340 425 255
Decision Making Skills 35 70 105 140 175 290
Design Knowledge 35 70 105 140 175 290
Critical Thinking Skills 60 120 180 240 300 375
Oral and Written Statement Capabilities 35 70 105 140 175 430

Total Points for Development Job Structure: 620

Customer Service

Compensable Factor Total
Degree 1 2 3 4 5
Customer Service Knowledge 85 170 255 340 425 85
Computer Skills 35 70 105 140 175 120
Critical Thinking Skills 35 70 105 140 175 120
Critical Thinking Skills 60 120 180 240 300 205
Oral and Written Statement Capabilities 35 70 105 140 175 155

Total Points for Customer Service Job Structure: 345

References

NAICS (2017). 512250 – Record Production and Distribution. Retrieved from https://www.naics.com/naics-code-description/?code=512250#topbusinesses

Martocchio, J.J. (2015). Strategic compensation: A human resource management approach, 8th edition. Upper Saddle River, New Jersey: Pearson Education, Inc.

O*Net Online. (2015). Retrieved from the Occupational Job Handbook Guide at http://www.onetonline.org

The role of DNP Scholar in leading change

The role of DNP Scholar in leading change

The knowledge to action model provides an opportunity in promoting practice change as it focuses on initiating the utilization of research knowledge in discerning the underlying issues of concern for practitioners. The knowledge to action model incorporates various healthcare stakeholders in translating knowledge to practice in developing evidence-based solutions for the nursing practice problems (Heckman et al. 2021). Besides, inter-professional teams play a critical role in enhancing the staff relationship and communication by perceiving positive healthcare outcomes for different patient groups. Through the inter-professional teams, healthcare practitioners bring together diverse knowledge base, experience, and expertise to guarantee patient safety and improve health outcomes through reduced inefficiencies. Additionally, empowering teams provides an effective strategy for inspiring individuals to embrace change (Nilsen et al. 2020). It is imperative to prepare the healthcare teams for change while promoting their involvement and enlightening them of the change process’s perceived benefits.

Week 1

According to the Global Burden of Disease Research, nursing personnel shortage is a national practice problem (Global Burden of Disease Research, 2020). The scarcity of healthcare nursing personnel worldwide poses negative consequences to the population health outcomes. First, the practice problems constrain nurses’ ability to meet the healthcare demands, resulting in nurse burnout cases and, consequently, medical errors. Globally, healthcare organizations and institutions have to increase their spending in meeting the growing global demands for healthcare needs. While recognizing nurses’ critical role in customizing patient care, the overwhelming need for care with the limited nursing professionals overwhelms their scope and practice. Additionally, the practice problem limits healthcare organizations’ ability to promote overall population health. While healthcare institutions are responsible for meeting the healthcare needs of diverse populations, the nursing shortage may result in medical inefficiencies, high mortalities, and litigation in the failure to honor the duty of care.

The state professional nursing associations are significant stakeholders in providing quality healthcare outcomes. The professional associations are affected by nursing shortages with considerable impact on their ability to promote positive healthcare outcomes. Some of the stakeholders involved in resolving the practice problem include; state and local healthcare departments, nursing managers, and patient associations. According to Drennan & Ross (2019), the clinical practice guidelines are fundamental in addressing the practice problem of nursing shortages. It focuses on reviewing the underlying evidence in optimizing patient care. The nurse-patient ratio provides a clinical practice guideline that provides a basis for scaling solutions to address the practice problem by insight into the patient populations’ critical public health needs.

Week 2

The nursing shortage results in a dissatisfied workforce within the healthcare institutions at the local level. In nursing care, nurses’ shortage culminates in increased burnout cases as nurses have to attend numerous. The national problem deteriorates the quality of nursing care, resulting in the potential for medical errors and misdiagnosis, resulting in higher morbidity and mortality rates due to inadequate provision of timely emergency and critical care. The nursing shortage ultimately deteriorates the quality of care for the local population due to the inefficiency in meeting the population’s daily healthcare and medical needs. Within the local setting, the stakeholders include; nurses, healthcare managers, clinicians, physicians, and the local health departments tasked with the responsibility of promoting universal health outcomes. In addressing the problem, the implementation of onboard nursing programs and staffing to reduce the nurse shortages has been imperative to promoting efficient nursing outcomes through collaboration with medical learning institutions. Indeed, the program is effective as it bridges the gap in knowledge transfer and reduces nursing care disparity.

 

References

Drennan, V. M., & Ross, F. (2019). Global nurse shortages—the facts, the impact, and action for change. British Medical Bulletin130(1), 25-37. https://doi.org/10.1093/bmb/ldz014

Heckman, G. A., Boscart, V., Quail, P., Keller, H., Ramsey, C., Vucea, V., King, S., Bains, I., Choi, N., & Garland, A. (2021). Applying the knowledge-to-Action framework to engage stakeholders and solve shared challenges with person-centered advance care planning in long-term care homes. Canadian Journal on Aging / La Revue canadienne du vieillissement, 1-11. https://doi.org/10.1017/s0714980820000410

Global Burden of Disease Research (2020). Global, regional, and national burden of accidental carbon monoxide poisoning, 1990–2019: A systematic analysis for the global burden of disease study 2019. https://doi.org/10.21203/rs.3.rs-129365/v1

Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: An interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research20(1). https://doi.org/10.1186/s12913-020-4999-8

The role of DNP Scholar in leading change

The role of DNP Scholar in leading change

The knowledge to action model provides an opportunity in promoting practice change as it focuses on initiating the utilization of research knowledge in discerning the underlying issues of concern for practitioners. The knowledge to action model incorporates various healthcare stakeholders in translating knowledge to practice in developing evidence-based solutions for the nursing practice problems (Heckman et al. 2021). Besides, inter-professional teams play a critical role in enhancing the staff relationship and communication by perceiving positive healthcare outcomes for different patient groups. Through the inter-professional teams, healthcare practitioners bring together diverse knowledge base, experience, and expertise to guarantee patient safety and improve health outcomes through reduced inefficiencies. Additionally, empowering teams provides an effective strategy for inspiring individuals to embrace change (Nilsen et al. 2020). It is imperative to prepare the healthcare teams for change while promoting their involvement and enlightening them of the change process’s perceived benefits.
Week 1
According to the Global Burden of Disease Research, nursing personnel shortage is a national practice problem (Global Burden of Disease Research, 2020). The scarcity of healthcare nursing personnel worldwide poses negative consequences to the population health outcomes. First, the practice problems constrain nurses’ ability to meet the healthcare demands, resulting in nurse burnout cases and, consequently, medical errors. Globally, healthcare organizations and institutions have to increase their spending in meeting the growing global demands for healthcare needs. While recognizing nurses’ critical role in customizing patient care, the overwhelming need for care with the limited nursing professionals overwhelms their scope and practice. Additionally, the practice problem limits healthcare organizations’ ability to promote overall population health. While healthcare institutions are responsible for meeting the healthcare needs of diverse populations, the nursing shortage may result in medical inefficiencies, high mortalities, and litigation in the failure to honor the duty of care.
The state professional nursing associations are significant stakeholders in providing quality healthcare outcomes. The professional associations are affected by nursing shortages with considerable impact on their ability to promote positive healthcare outcomes. Some of the stakeholders involved in resolving the practice problem include; state and local healthcare departments, nursing managers, and patient associations. According to Drennan & Ross (2019), the clinical practice guidelines are fundamental in addressing the practice problem of nursing shortages. It focuses on reviewing the underlying evidence in optimizing patient care. The nurse-patient ratio provides a clinical practice guideline that provides a basis for scaling solutions to address the practice problem by insight into the patient populations’ critical public health needs.
Week 2
The nursing shortage results in a dissatisfied workforce within the healthcare institutions at the local level. In nursing care, nurses’ shortage culminates in increased burnout cases as nurses have to attend numerous. The national problem deteriorates the quality of nursing care, resulting in the potential for medical errors and misdiagnosis, resulting in higher morbidity and mortality rates due to inadequate provision of timely emergency and critical care. The nursing shortage ultimately deteriorates the quality of care for the local population due to the inefficiency in meeting the population’s daily healthcare and medical needs. Within the local setting, the stakeholders include; nurses, healthcare managers, clinicians, physicians, and the local health departments tasked with the responsibility of promoting universal health outcomes. In addressing the problem, the implementation of onboard nursing programs and staffing to reduce the nurse shortages has been imperative to promoting efficient nursing outcomes through collaboration with medical learning institutions. Indeed, the program is effective as it bridges the gap in knowledge transfer and reduces nursing care disparity.

References
Drennan, V. M., & Ross, F. (2019). Global nurse shortages—the facts, the impact, and action for change. British Medical Bulletin, 130(1), 25-37. https://doi.org/10.1093/bmb/ldz014
Heckman, G. A., Boscart, V., Quail, P., Keller, H., Ramsey, C., Vucea, V., King, S., Bains, I., Choi, N., & Garland, A. (2021). Applying the knowledge-to-Action framework to engage stakeholders and solve shared challenges with person-centered advance care planning in long-term care homes. Canadian Journal on Aging / La Revue canadienne du vieillissement, 1-11. https://doi.org/10.1017/s0714980820000410
Global Burden of Disease Research (2020). Global, regional, and national burden of accidental carbon monoxide poisoning, 1990–2019: A systematic analysis for the global burden of disease study 2019. https://doi.org/10.21203/rs.3.rs-129365/v1
Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: An interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-4999-8

The Role of the DNP Scholar in Leading Change

Which translation model provides a framework for practice change?
What is the value of an interprofessional team to address this practice problem?
In influencing improvement outcomes to address this problem, what strategies can you implement to inspire others to embrace change?

*Week 1: National Practice Problem Exploration
Evidence translation begins with the identification of a problem or concern. Reflect upon the eight national practice problems presented in the Global Burden of Disease Research. Select one of the practice problems to address the following.

From a global/nationwide perspective, how does the selected practice problem impact nurses, nursing care, healthcare organizations, and the quality of care being provided?
Identify the national level key stakeholders who are affected by the practice problem and stakeholders involved in resolution.
Are clinical practice guidelines used to address this problem? Why or why not? If used, provide a brief overview of the CPG. If a CPG is not used, propose an intervention that could be implemented on a national scale to address the problem.
Week 2: Local Practice Problem Exploration
Reflect upon the selected national practice problem in Week 1 to address the following.
———
From a local perspective, how does the practice problem impact nurses, nursing care, healthcare organizations, and the quality of care being provided?
Identify the local key stakeholders related to the selected practice problem.
Describe one approach used at your unique setting to address this problem. From your perspective, is this intervention effective in addressing the problem? Why or why not? If this practice problem is not addressed at your workplace, propose an intervention that could be implemented on a local scale to address the problem.

 

CHA2DS2 VASc score

CHA2DS2 VASc score

CHA2DS2

My response to the patient’s request would begin with informing her that changing her medication to one of the coagulants her friend takes would necessitate assessing the risk for bleeding, among other effects likely to occur. Specifically, I would inform the patient that determining the bleeding risk would involve calculating the HAS-BLED score, facilitating determining modifiable risk factors. I would further tell her that there are different types of atrial fibrillation, the condition for which she is receiving current treatment (Wojszel et al. 2019). Due to these differences, patients have unique risk factors attributed to a possible stroke. Based on the patient’s age, changing her current treatment regimen would intensify the susceptibility to other comorbidities and ultimately mortality. Besides, the treatment regimen prepared for one patient may not be suitable for another individual or maybe a misfit for managing the disease and any other underlying conditions (Da Costa Bronchtein, 2020).

Patient Education

Indeed, the anticoagulation medication should be considered for any patient with a CHA2DS2 VASc of 2 or more, which in this case, the patient has a score of 6. However, the anticoagulant medication choice should consider factors such as the patient’s weight and the current stroke and bleeding risks. If the coagulant is deemed appropriate for the patient, it would be more convenient due to its rapid onset of action, lack of regular monitoring, and minimal drug interactions (Ekerstad, Karlsson, Söderqvist, & Karlson, 2018). The patient stated that she no longer drives and has difficulty obtaining rides to the lab. The appropriate coagulant’s identification and prescription would address these issues and allow the patient to recover while at home.

Nonetheless, the side effects associated with the change to anticoagulation medications include minimal exposure of the drug, short half-life, and reduced concentration at peak with weight increase, intensifying the risk for under-dosing (Wojszel et al. 2019). Besides, there is a risk of thromboembolic events and bleeding complications and renal impairment during excretion at the patient’s age. Additionally, anticoagulants, such as Warfarin, have been associated with drug interactions with various drugs and foods. Thus, their concurrent use should be thoroughly considered (Da Costa Bronchtein, 2020).

References

Da Costa Bronchtein, A. I. (2020). Challenges for anticoagulation in atrial fibrillation. International Journal of Cardiovascular Scienceshttps://doi.org/10.36660/ijcs.20190003

Ekerstad, N., Karlsson, T., Söderqvist, S., & Karlson, B. W. (2018). Hospitalized frail elderly patients – atrial fibrillation, anticoagulation, and 12 months’ outcomes. Clinical Interventions in Aging13, 749-756. https://doi.org/10.2147/cia.s159373

Wojszel, Z. B., Kasiukiewicz, A., Swietek, M., Swietek, M. L., & Magnuszewski, L. (2019). CHA2DS2-vasc score can guide the screening of atrial fibrillation – cross-sectional study in a geriatric ward. Clinical Interventions in Aging14, 879-887. https://doi.org/10.2147/cia.s206976

Community Engagement Portfolio

Community Engagement Project Portfolio

 

Portfolio Checklist

Part One – Essential Scrapbook Evidence

No Content (1500 words)
1. Patient/service user profile
2. Community profile including qualitative and quantitative data
3. Identified public health challenge
4. Record of person-centred narrative
5. Reference list of data sources (electronic and published data)

Part Two – Systematic Summary Report

 

Written Assignment (1500 words)
To include:

·      Introduction

·      Statement of learner’s intent

·      Key issues identified through portfolio

·      Conclusion and recommendations

·      Reference list

 

Appendices

 

No Content
1. Log of activities demonstrating understanding of the topic  
2. Log of seminars/discussions with the module lead  
3. Log of meetings/discussions with inter-professional colleagues  
4. Supplementary material (additional/optional)  

 

 

 

 

 

 

 

Part One – Essential Scrapbook Evidence

  1. Patient/Service User Profile

Mr. X, 58 years and a father of four, has been a regular visitor at our facility for several years. Born and bred in Southend, Mr. X was diagnosed with diabetes ten years ago following a routine check-up of his physical well-being and mental functionality. Based on assessing his behavioural and social characteristics, Mr. X admitted that he has smoked tobacco since he was a teenager. As a common and significant public health issue facing Southend, Essex, and England, smoking has become a prevalent occurrence associated with adverse eventualities and chronic illnesses among the people. The additional determinants of health that impacted Mr. X’s experience include genetics as his parents were smokers and his father had diabetes. Similarly, the environment in which he grew up predisposed him to start smoking tobacco at a young age. At the same time, his behavioural and social traits have been characterised by continued smoking, drinking beer regularly, and lack of physical activity (Kemppainen, Tossavainen, & Turunen, 2012). As a result of these factors, Mr. X and his wife have been obese for more than a decade, which has further intensified their risk for developing diabetes and other chronic illnesses.

  1. Community Profile

According to Public Health England (PHE) (2019), the life expectancy at birth for males living in Southend was valued at 79.1 years between 2017 and 2019, while females were averaged at 82.5 years during the same period. These rates were relatively lower than those in England, 79.1 years among and 83.4 years among women, and 80.5 and 83.5 years for men and women respectively across the region. However, they were averagely better than the worst scenarios estimated throughout England at 74.4 years for men and 79.5 years for women. The best life expectancy at birth rates reported in England was 84.9 years for men and 87.2 years for women. Similarly, the under 75 mortality rates from all cases recorded in Southend between 2017 and 2019 were 353, while those in England and across the region were 326 and 298, respectively (PHE, 2020). The best and worst cases reported recorded in England and throughout the region were 224 and 548, respectively. The mortality rates for people below 75 years from all cardiovascular diseases within Southend between 2017 and 2019 were 75.5 per 100,000, while those in England and across the region were 70.4 and 62.9 per 100,000. The best and worst cases within England and across the regions were valued at 43.6 per 100,000 and 121.6 per 100,000 (PHE, 2020).

Additionally, the under 75 mortality rates from cancer reported in Southend between 2017 and 2019 was 141.6 per 100,000, while those in England and the region were 129.2 and 122.6 per 100,000, respectively. The best and worst cases reported within England and throughout the region were valued at 87.4 and 182.4 per 100,000. During this period, the suicide rates reported in Southend were 13.2 per 100,000 individuals, while those in England and throughout the region were 10.1 and 10.5 per 100,000 individuals. The best and worst suicide rates reported ranged between 4.9 and 19.0 per 100,000 individuals (SBC, 2019).

Besides, Southend is ranked 56th out of 149 local authorities in the region regarding child obesity incidents reported between 2018 and 2019. During this period, the best and worst cases of childhood obesity were recorded in Richmond upon Thames, ranked the first position, and Wolverhampton ranked 149th, thereby making Southend an above-average local authority (SBC, 2019). Similarly, in regards to the NHS’s health checks, Southend was ranked 24th out of the 149 local authorities between 2018 and 2019. The top position was scooped by Hammersmith and Fulham, while the last position went to East Riding of Yorkshire. These rankings were followed closely by Southend scooping position 80 out of 140 local authorities in terms of tobacco control between 2018 and 2019. The first positions went to Richmond upon Thames, while Kingston upon Hull was ranked last (SBC, 2021). This ranking positioned Southend in a worse than average place among the region’s local authorities.

In terms of alcohol treatment, the City of London was ranked position one, Southend scooped position 72, and Devon came last out of the 131 local authorities. Similar ratings were recorded regarding drug treatment among the 141 local authorities as the City of London scooped the first position, Southend came in at position 19. In contrast, Kingston upon Hull came in last (SBC, 2021). As a result, Southend was ranked position 18 out of the best local authorities to start in life, while Waltham Forest scooped position one and Kirklees scooped the last position. In terms of sexual and reproductive health, Hackney was position one out of 147 local authorities, Southend came at position 147, while Stockton-on-Tees scooped the last position. In a survey on the air quality and management areas (AQMAs), Halton had 0%, as per 2017, while Southend had a rating of 0.2%, scooping position 14, and Westminster 100th out of 131 local authorities (PHE, 2019).

  1. Identified Public Health Challenge

PHE (2019) pointed out that the overall life expectancy for Southend’s population has since the 1990s risen dramatically by over five years for men and over three years for men. However, mortality rates among infants have declined more than halved. The most significant contributor to the life expectancy increase has been associated with a significant reduction in the premature mortality rates from cardiovascular disease (CVD). Additionally, the substantial decline in mortality rates related to CVD has occurred due to a decrease in smoking rates, dietary changes, improved access to preventive medication and treatment regimens (NICE, 2008). Although Southend-on-Sea has and continues to develop new strategies to boost reduction in smoking rates, substance and alcohol abuse, and gambling, the issues remain prevalent within the population (NHS, 2021).

Smoking, as the health issue discussed in this report, has brought catastrophic eventualities to the people of Southend, as portrayed below:

  • 962 adult deaths reported between 2015 and 2017 due to smoking, a rate of 295 per 100,000, which was worse than the average in England (263 per 100,000) (PHE, 2018)
  • 2,011 hospital admissions in 2016 and 2017 due to smoking
  • £ 3.1 million costs incurred by the NHS (NHS, 2021)
  • Smoking prevalence among adolescents (15-year-olds) was rated at 10%, similar to that of England between 2014 and 2015
  • Prevalence among adults was rated 18% in 2017, worse than that of England (15%) (PHE, 2019)
  • Smoking prevalence among pregnant women between 2017 and 2018 was rated at 11%, similar to that of England (PHE, 2019)
  • Among adults with serious mental illnesses (SMIs), the prevalence rate was 45%, worse than that of England at 41% between 2014 and 2015
  • Smoking prevalence in adults in manual and routine occupations was 26.8%, worse than that of England and throughout the region, at 25.4% and 25.7%, respectively (PHE, 2020)

In the recent past, Southend and England, in general, have experienced significant increases in access to and the quality of healthcare, coupled with substantial growth in health resources. Indeed, the environment people live has a significant influencer on their physical and mental welfare and can further hinder healthy decision-making (SBC, 2019). As a result, Public Health England, alongside other entities, has identified seven priorities to focus their efforts on promoting health among the people of Southend and throughout England. These priorities include securing improvements in reducing smoking and preventing children from engaging in this habit. These activities have been followed by tackling the obesity menace in Southend and throughout England, especially in children. It has further been coupled with the reduction of harmful consumption of alcohol and related hospital admissions (SBC, 2021). Additionally, PHE and the relevant stakeholders in England have set out to ensure that each child develop in the right way, reduces the risks of dementia, and its prevalence among older adults, and addresses issues related to growth in antimicrobial resistance. They have further set out to achieve an annual decline in tuberculosis incidence (PHE, 2021).

The PHE recognizes that attaining these goals is a challenging task that necessitates collaboration and partnership with the local and central authorities, clinical commissioning groups, and the wider NHS, alongside other entities and groups, to boost commitment and support for promoting health (NHS, 2021). Most fundamentally, nurses and other healthcare providers have been at the forefront in promoting health within Southend and throughout England. Their operations concerning reducing smoking, especially among 15-year-olds and other age sets, have entailed initiating 500,000 quit attempts through campaigns aimed at smoking cessation, including the Stoptober initiative, and developing tools to support effective commissioning. These measures have been coupled with regular and routine check-ups with health facilities in Southend and throughout England (PHE, 2020).

  1. Record of Person-centred Narrative

Smoking remains England’s biggest health challenge that causes approximately 80,000 premature mortality annually and brings along a myriad of illnesses. Today, almost eight million people smoke in England, with a big proportion having developed the habit in their teenage years. Another set of people engaged in this behaviour entails pregnant women. Smoking during pregnancy has led to 2,200 premature births, 5,000 miscarriages, and more than 300 perinatal deaths annually throughout the UK (PHE, 2021). Mr. X started smoking as a teenager, and during the birth of their firstborn son, his wife was smoking as well. Today, their son is 23 years old, and he and his fiancé are smokers. Within the community, Mr. X stated that he has come across numerous teenagers who smoke and engage in other undesirable behaviours that include substance abuse.

Reference list for Part One

References

Age UK. (2019). Improving health and well-being in Mid and South Essex. July-2019-Health-and-wellbeing-resources-pack-for-mid-and-south-Essex-compressed.pdf, 1-50. https://www.ageuk.org.uk/globalassets/age-uk/documents/programmes/health-and-wellbeing-alliance/july-2019-health-and-wellbeing-resources-pack-for-mid-and-south-essex-compressed.pdf

JSNA. (2016). A Local Guide to Health Needs Assessments- 2016. Joint Strategic Needs Assessment (JSNA), 1-2. https://www.southdevonandtorbay.info

JSNA. (2019). Essex Countywide report. Joint Strategic Needs Assessment (JSNA) 2019. https://cmis.essex.gov.uk/essexcmis5/Document.ashx?czJKcaeAi5tUFL1DTL2UE4zNRBcoShgo=0j2Cl10xBy8FeoppSl8d6Q4T5vm1Km0AJWzeXTmK%2BjuopxlGt4NY2Q%3D%3D&rUzwRPf%2BZ3zd4E7Ikn8Lyw%3D%3D=pwRE6AGJFLDNlh225F5QMaQWCtPHwdhUfCZ%2FLUQzgA2uL5jNRG4jdQ%3D%3D&mCTIbCubSFfXsDGW9IXnlg%3D%3D=hFflUdN3100%3D&kCx1AnS9%2FpWZQ40DXFvdEw%3D%3D=hFflUdN3100%3D&uJovDxwdjMPoYv%2BAJvYtyA%3D%3D=ctNJFf55vVA%3D&FgPlIEJYlotS%2BYGoBi5olA%3D%3D=NHdURQburHA%3D&d9Qjj0ag1Pd993jsyOJqFvmyB7X0CSQK=ctNJFf55vVA%3D&WGewmoAfeNR9xqBux0r1Q8Za60lavYmz=ctNJFf55vVA%3D&WGewmoAfeNQ16B2MHuCpMRKZMwaG1PaO=ctNJFf55vVA%3D

NHS. (2021). Southend, Essex, and Thurrock Mental Health and well-being Strategy. Appendix 1 MH Strategy – Master Document MER V3a – SET 003.pdf. https://southend.moderngov.co.uk/documents/s8131/Appendix%201%20MH%20Strategy%20-%20Master%20Document%20MER%20V3a%20-%20SET%20003.pdf

PHE. (2013). Nursing and Midwifery Contribution to Public Health Improving health and well-being. Public Health England (PHE), 1-14. https://www.gov.uk/government/organisations/public-health-england

PHE. (2014). From evidence into action: opportunities to protect and improve the nation’s health. Public Health England, 1-28. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/366852/PHE_Priorities.pdf

PHE. (2018, July 3). Southend-on-Sea Unitary authority. Public Health England: The – Southend-on-Sea Borough Council. https://www.southend.gov.uk/downloads/file/3828/southend-on-sea_health_profile_2015

PHE. (2019). Protecting and Improving the Nation’s Health PHE Strategy 2020-2025. (Public Health England)https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/831562/PHE_Strategy_2020-25.pdf

Public Health England (PHE). (2019). Local authority health profiles – PHE. Public Health Profiles – PHE. https://fingertips.phe.org.uk/profile/health-profiles/data#page/1/gid/1938132696/pat/6/par/E12000006/ati/202/are/E06000033/cid/4

Public Health England (PHE). (2020). Public health profiles – Area details. Public Health Profiles – PHE. https://fingertips.phe.org.uk/topic/public-health-dashboard/area-details#are/E06000033/ati/202/gid/1938133162/par/E92000001

Public Health England (PHE). (2021). Local tobacco control profiles – PHE. Public Health Profiles – PHE. https://fingertips.phe.org.uk/profile/tobacco-control/data#page/1/gid/1938132885/pat/6/par/E12000006/ati/102/are/E06000033/cid/4

SBC. (2019). Director of Public Health Annual Report 2018-19. The – Southend-on-Sea Borough Council. https://www.southend.gov.uk/downloads/file/6600/annual-public-health-report-2018

SBC. (2021). Health and well-being – Southend-on-Sea Borough council. Southend-on-Sea Borough Council (SBC). https://www.southend.gov.uk/southend-insights/health-wellbeing-2

Southend-on-Sea Borough Council (SBC). (2021). Southend-on-Sea ward health profiles – Southend-on-Sea Borough council. Southend-on-Sea Borough Council. https://www.southend.gov.uk/downloads/download/824/southend-on-sea_ward_health_profiles

Watkins, S. (2017). Southend-on-Sea Localities Needs Profile: East. NHS- Southend Clinical Commissioning Group.
https://southendccg.nhs.uk/about-us/key-documents/strategic-plan-related-documents/3284-01-local-needs-profile-southend-east/file

 

 

 

 

 

 

 

 

 

 

 

 

Part Two – Systematic Summary Report

In nursing practice, community profiling facilitates a determining population’s health needs. It fosters an understanding of the extent to which public health issues affect people’s well-being and the identification of the appropriate ways to address them. As a high-priority practice, community profiling focuses on health across the entire population. It considers working with the community and other groups and organizations to plan and implement interventions depending on the needs of the local community (Stonehouse, 2017). Based on the public health issues identified, nurses, alongside other health professionals and the agencies within the community, are strategically placed to adopt the role of recognising the needs of their community (Poulton, 2009). These individuals, groups, and organizations further come together in planning effective treatment regimens and focus on guaranteeing the access and availability of appropriate services. The attainment of these objectives occurs through an in-depth assessment of the community’s health needs, a thorough review of health issues facing the population, and the identification of new health priorities (Watkins, 2017).

Statement of the Learner’s Intent

Since various communities are faced with distinct health needs, community profiling based on assessing the factors affecting the population’s well-being significantly contributes to the identification of other underlying components that should be addressed (WHO, 2009). The community profiling and assessment measures focus on primary needs that include comparative, expressed, felt, and normative components. The normative needs include those defined by health professionals as impediments to an individual norm. For instance, nurses consider the primary need in a diabetes patient to be lifestyle changes aimed at reducing his/her body weight (Motamed, 2019). The felt needs include the individuals’ perceptions of what he/she wants. In the case of the diabetic patient above, he/she may perceive the need to make some changes in his/her lifestyle to reduce his body mass index. Expressed and comparative needs include those highlighted by the patient and those identified upon comparing the community with another (JSNA, 2016). In this case, the primary intent entailed community profiling by focusing on Southend-on-Sea as a community within England. It further involves an emphasis on the public health issue, smoking, and analysing the extent to which it has affected the population. These components have been identified by comparing the effects of smoking in England and throughout the region. It has further involved analysing the measures put in place to address the public health issue by incorporating the community members and other relevant stakeholders (Davies, 2019).

Key Issues identified through the Portfolio

Based on the application of the health needs assessment process, this community profiling portfolio focused on smoking as the public health issue facing the people of Southend and England, in general, Age UK, 2019. This assessment processed involved a series of activities such as identifying the population by focusing on an individual’s point of view, Mr. X. It further focused on identifying the parties involved and incorporating their experiences with the public health issue (Jack & Holt, 2008). These elements were followed closely by identifying the health priorities within the population, the perceptions of needs, and the assessment of the health conditions and determinant factors. Among the significant issues identified in the Southend community includes significant improvements in the access to and availability of healthcare services and changes in the incidence and prevalence of health conditions (Binns & Low, 2015).

Life Expectancy and Mortality Rates  

Specifically, an assessment of the behavioural risk factors revealed that the current population of smokers (18+ years) in Southend was 58.4%, worse than the rate in England in the period between 2011 and 2017, 17.2 to 21.8%. Besides, Southend’s assessment indicated that, in 2017, the estimated prevalence of smoking in Southend was 19.1%, worse than in England. Additionally, the life expectancy at birth for males living in Southend was valued at 79.1 years between 2017 and 2019, while females were averaged at 82.5 years during the same period (PHE, 2021). These rates were relatively lower than those in England, 79.1 years for men and 83.4 years for women, and 80.5 Years for men and 83.5 years across the region. However, they were averagely better than the worst scenarios estimated throughout England at 74.4 years for men and 79.5 years for women. The best life expectancy at birth rates reported in England was 84.9 years for men and 87.2 years for women.

Similarly, the under 75 mortality rates from all cases recorded in Southend between 2017 and 2019 were 353, while those in England and across the region were 326 and 298, respectively (Poulton, 2009). The best and worst cases reported recorded in England and throughout the region were 224 and 548, respectively (PHE, 2020). The mortality rates of people below 75 years from all cardiovascular diseases within Southend between 2017 and 2019 were 75.5 per 100,000, while those in England and across the region were 70.4 and 62.9 per 100,000. The best and worst cases within England and across the regions were valued at 43.6 per 100,000 and 121.6 per 100,000 (PHE, 2019).

Additionally, the mortality rates associated with cancer among people below 75 years reported in Southend between 2017 and 2019 was 141.6 per 100,000, while those in England and the region were 129.2 and 122.6 per 100,000, respectively. The best and worst cases reported within England and throughout the region were valued at 87.4 and 182.4 per 100,000 individuals (PHE, 2019). During this period, the suicide rates reported in Southend were 13.2 per 100,000 individuals, while those in England and throughout the region were 10.1 and 10.5 per 100,000 individuals. The best and worst suicide rates reported ranged between 4.9 and 19.0 per 100,000 individuals.

Illness and Hospital Admissions

Besides, Southend is ranked 56th out of 149 local authorities in the region regarding child obesity incidents reported between 2018 and 2019. During this period, the best and worst cases of childhood obesity were recorded in Richmond upon Thames, ranked the first position, and Wolverhampton ranked 149th, thereby making Southend an above-average local authority (PHE, 2019). Similarly, in regards to the NHS’s health checks, Southend was ranked 24th out of the 149 local authorities between 2018 and 2019 (NHS, 2021). The top position was scooped by Hammersmith and Fulham, while the last position went to East Riding of Yorkshire. These rankings were followed closely by Southend scooping position 80 out of 140 local authorities in terms of tobacco control between 2018 and 2019. The first positions went to Richmond upon Thames, while Kingston upon Hull was ranked last. This ranking positioned Southend in a worse than average place among the region’s local authorities (JSNA, 2016).

In terms of alcohol treatment, the City of London was ranked position one, Southend scooped position 72, and Devon came last out of the 131 local authorities. Similar ratings were recorded regarding drug treatment among the 141 local authorities as the City of London scooped the first position, Southend came in at position 19. In contrast, Kingston upon Hull came in last (NHS, 2021). As a result, Southend was ranked position 18 out of the best local authorities to start in life, while Waltham Forest scooped position one and Kirklees scooped the last position. In terms of sexual and reproductive health, Hackney was position one out of 147 local authorities, Southend came at position 147, while Stockton-on-Tees scooped the last position (PHE, 2018). As mentioned in section 1, a survey on the air quality and management areas (AQMAs), Halton had 0%, as per 2017, while Southend had a rating of 0.2%, scooping position 14, and Westminster and ranked a 100th out of 131 local authorities (PHE, 2018).

Conclusion and Recommendations

Following the basic concepts in public health practices, this community profiling portfolio set out to deal with the health of the population in Southend instead of the adoption of clinical objectives that epitomize restoration, maintenance, and improvement of an individual’s well-being. Although identifying the various public health issues facing the people of Southend involved assessment based on an individual’s perspective, it sought to improve the well-being of the community, in general. The attainment of this objective involved emphasis on protecting the people, preventing the occurrence and prevalence of diseases, and promoting the population’s well-being. To better understand the extent of the public health issue, smoking, in Southend, it is imperative to assess epidemiology principles that provide tools for comprehending its exacerbation patterns, risk factors, and the outcomes of prevention and treatment activities.

Among the significant issues identified include the prevalence of smoking among the public starting at a young age, pregnant women, and individuals across all ages. Its prevalence predisposes smokers to numerous adverse eventualities, including premature mortality, various cancers, cardiovascular disease, diabetes, and other severe health conditions. In assessing Mr. X’s case, it becomes apparent that smoking is a generational public health challenge that has affected the population. To address these issues, the local authorities must consider imposing laws regulating access to cigarettes and tobacco in general. For instance, the local authorities, working hand-in-hand with healthcare professionals and other entities in Southend should increase the legal age limit of smoking to 21 years and further ban smoking in public as ways to regulate its access.

 

 

 

 

 

 

 

 

 

Reference list for Part Two

References

Binns, C., & Low, W. (2015). What is public health? Asia Pacific Journal of Public Health27(1), 5-6. https://doi.org/10.1177/1010539514565740

Davies, J. (2019, July 31). Public Health England issue urgent advice after six suspected drug-related deaths in South Essexhttps://www.essexlive.news/news/essex-news/public-health-england-issue-urgent-3158536

Jack, K., & Holt, M. (2008). Community profiling as part of a health needs assessment. Nursing Standard22(18), 51-56. https://doi.org/10.7748/ns2008.01.22.18.51.c6311

JSNA. (2016). A Local Guide to Health Needs Assessments- 2016. Joint Strategic Needs Assessment (JSNA), 1-2. https://www.southdevonandtorbay.info

Kemppainen, V., Tossavainen, K., & Turunen, H. (2012). Nurses’ roles in health promotion practice: An integrative review. Health Promotion International28(4), 490-501. https://doi.org/10.1093/heapro/das034

Motamed, S. (2019). Health promotion, community-campus-local authorities’ partnership, and new health professional profile. European Journal of Public Health29(Supplement_4). https://doi.org/10.1093/eurpub/ckz186.428

NICE. (2008, February). NICE public health guidance 9: Community engagement to improve health. National Institute for Health and Clinical Excellence (NICE). www.nice.org.uk/PH009

PHE. (2013). Nursing and Midwifery Contribution to Public Health Improving health and well-being. Public Health England (PHE), 1-14. https://www.gov.uk/government/organisations/public-health-england

PHE. (2014). From evidence into action: opportunities to protect and improve the nation’s health. Public Health England, 1-28. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/366852/PHE_Priorities.pdf

Poulton, B. (2009). Barriers and facilitators to the achievement of community-focused public health nursing practice: A UK perspective. Journal of Nursing Management17(1), 74-83. https://doi.org/10.1111/j.1365-2834.2008.00949.x

Public Health England (PHE). (2019). Local authority health profiles – PHE. Public Health Profiles – PHE. https://fingertips.phe.org.uk/profile/health-profiles/data#page/1/gid/1938132696/pat/6/par/E12000006/ati/202/are/E06000033/cid/4

SBC. (2019). Director of Public Health Annual Report 2018-19. The – Southend- on- Sea Borough Council. https://www.southend.gov.uk/downloads/file/6600/annual-public-health-report-2018

SBC. (2021). Health and well-being – Southend-on-Sea Borough council. Southend-on-Sea Borough Council (SBC). https://www.southend.gov.uk/southend-insights/health-wellbeing-2

Stonehouse, D. (2017). Understanding the Nursing Process. British Journal of Healthcare Assistants (BJHA)11(08), 388-391. https://www.magonlinelibrary.com/doi/abs/10.12968/bjha.2017.11.8.388?af=R

Tannahill, A. (2009). Health promotion: The Tannahill model revisited. Public Health123(12), 396-399. https://doi.org/10.1016/j.puhe.2009.05.009

Watkins, S. (2017). Southend-on-Sea Localities Needs Profile: East. NHS- Southend Clinical Commissioning Group.
https://southendccg.nhs.uk/about-us/key-documents/strategic-plan-related-documents/3284-01-local-needs-profile-southend-east/file

WHO. (2009). Milestones in Health Promotion: Statements from Global Conferences. World Health Organization (WHO). https://www.who.int/healthpromotion

Appendices

  1. Log of activities
Activity no: Date Activity
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  1. Log of seminars/discussions with Module Lead / Personal Tutor
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  1. Log of meetings/discussions with inter-professional colleagues
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Managerial Economics Case Study

Managerial Economics Case Study

Managerial Economics Case Study

Executive Summary

A leading manufacturer, producer, and distributor of oil, gas, and petrochemical products, ExxonMobil has established its operations in different parts of the world, including the United Kingdom and India. Conducting business in these countries necessitates adherence to the monetary, fiscal, political, and market requirements and further complying with governmental rules and policies that regulate the organization’s operations. As will be portrayed herein, ExxonMobil’s operations are characterized by various components shaping or influencing its sustainability within the nation and its surrounding neighbours. The depiction of these components will necessitate a thorough review of its economic activities’ monetary, fiscal, and political aspects. These will be coupled with an in-depth analysis and comparison of the countries in terms of their market structure, the effects of the major macroeconomic indicators, and local and foreign trade policies.

Introduction

Exxon Mobil Corporation entails an international oil and gas company based in Irving, Texas. Originated from Standard Oil, owned by John D. Rockefeller, ExxonMobil was formulated and established on November 30, 1999, through a merger between Exxon (formerly Standard Oil Company of New Jersey) and Mobil (the former Standard Oil Company of New York). The primary commodities associated with the company include Exxon, Mobil, Esso, and ExxonMobil Chemical (ExxonMobil, 2019). Throughout the years, its operations have contributed to ExxonMobil being ranked one of the leading firms globally in terms of revenue.

Most fundamentally, between 2016 and 2017, ExxonMobil ranged between the first position to sixth in terms of market capitalization and public trading. In 2016, the company was position three in the Forbes Global 2000 list, while in 2017, ExxonMobil was number ten among the companies that made the most profits, as per Fortune 500. Subsequently, in 2018, ExxonMobil position two out of the largest organizations in America, as stipulated by 500 rankings based on total revenue (ExxonMobil, 2019). These accomplishments have been characterized by company shares distributed across various local and international institutions. For instance, a large portion (55.56%) of ExxonMobil’s shares is owned by institutions such as The Vanguard Group with 8.15%, BlackRock with 6.61%, and State Street Corporation with 4.83%, as of 2019.

As one of the Big Oil companies globally, ranked 14th, ExxonMobil produced 20 billion barrels of oil equivalent (BOE) as of 2016. Besides, ExxonMobil owns 37 refineries in more than 21 nations, which constitute a cumulative refining capacity of approximately 6.3 million barrels (1,000,000 m3) daily, pushing the company to position seven among the most significant global refiners. Despite these accomplishments, ExxonMobil has enjoyed its fair share of criticism based on its slow response to cleaning up efforts following the 1989 Alaskan oil spill that brought immeasurable damage to the world’s environment (Chart Industries, 2020). Additionally, ExxonMobil has been associated with a long history of lobbying activities and efforts to deny climate change and objection to the global warming consensus. Thus, ExxonMobil has employed various measures in minimising the environmental impact of its global operations. Still, the company remains the target of accusations related to inadequately addressing human rights issues, American’s foreign policy influence, and its effect on other countries’ future.

Nonetheless, ExxonMobil remains the most significant company not owned by the government in the energy sector that produces an average of 3% of the oil and an estimated 2% of the world’s energy. (ExxonMobil, 2019) Therefore, this case’s essence entails an in-depth overview and analysis of ExxonMobil’s operations by focusing on two countries, the United Kingdom and India. The analysis will delve into the market structure in which ExxonMobil operates for and within the two countries. These elements will be followed closely by a comparative analysis and analysis of the major macroeconomic indicators between the two countries and their potential effect on the company’s economic activities. Ultimately, this case study will analyse the foreign trade policy instruments applied in both countries.

Research Problem/Question

A nation’s economy is shaped by the macroeconomic activities that bring in foreign investors and foster trade with different countries and regions. In this case, this report highlights ExxonMobil’s operations in two different countries, India and the United Kingdom, by focusing on their market structure and other macroeconomic indicators that influence the company’s economic activities. It will analyse the countries’ suitability for the company operations by epitomising the various indicators that affect the economy and trade activities.

Analysis

ExxonMobil’s operations are organized into different global divisions categorised into three groups: stand-alone and ancillary divisions such as Coals and Minerals (ExxonMobil, 2019). Today, ExxonMobil’s global operations are renowned for their popular brand names, Exxon, Esso, and Mobil. The company manufactures products that facilitate transportation in the modern world, powering cities, lubricating industries, and further providing petrochemical building blocks that foster numerous consumer goods (Chart Industries, 2020).

ExxonMobil focuses on exploring oil, extracting, shipping, and wholesale operations within its upstream division. The downstream division specializes in marketing, refining, and retail operations for the company’s products. Lastly, the chemical businesses division is a merger between Exxon’s and Mobil’s chemical industries with main products that include olefins and aromatics, synthetic lubricant base stocks and additives, catalysts, and polyethylene, among others (ExxonMobil, 2019). These operations foster the identification, capturing, and evaluation of new oil and gas resources in operation countries. However, most of the production fields in which ExxonMobil is interested, especially in the North Sea, are operated by other companies as part of a joint venture. As a result, working in various locations around the world, ExxonMobil has, over the years, powered the economy of the neighbouring countries with significant investments in economic growth (ExxonMobil, 2019). These elements have facilitated the exemplification of the company’s commitment to supporting the communities within which it operates through education and economic empowerment, the provision of infrastructure, human capacity development, and health.

 

ExxonMobil’s Operations in the United Kingdom and Market Structure Analysis

Under the upstream division, ExxonMobil’s operations in the United Kingdom have involved activities such as the exploration and production of petroleum. Specifically, ExxonMobil holds or owns an average of 0.6 million acres (2,400 km2) of the land on the United Kingdom’s offshore. ExxonMobil exploration activities have emphasized the identification, acquisition, and evaluation of new oil and gas resources (ExxonMobil, 2019). As of 2019, ExxonMobil’s production activities entailed targeting approximately 40 production offshore oil and gas fields along the North Sea. The majority of the areas in which the company had targeted were operated by Shell U.K., boosting explorative and production operations as part of a collaborative effort (ExxonMobil, 2019). The code of practice applied in access the oil and gas infrastructure within the United Kingdom entails a voluntary agreement put in place by Oil & Gas UK in consultation with the Depart of Business, Energy, and Industrial Strategy (BEIS).

ExxonMobil’s operations in the United Kingdom have facilitated its rise in rankings as the largest oil pipeline distribution network, with approximately 700 kilometres of pipeline. Most of the United Kingdom’s refinery products are transported by pipeline to distribution terminals at Avonmouth, Birmingham, Hythe, Purfleet, and West London. The remaining products are transported by road or sea (ExxonMobil, 2019). In 2015, ExxonMobil invested £254 million in the United Kingdom North Sea, boosting its responsibility to an average of 5% of the oil and gas produced in the country. This investment and production activities further supplied the United Kingdom and other global markets with approximately 80,000 barrels of oil and about 441 million cubic feet of gas daily. Best known for its famous brands, Esso and Mobil, ExxonMobil remains the largest retailer in petrol across the United Kingdom. Thus, it serves around 800,000 customers daily through its retail network that comprises 1,100 Esso-branded service stations. Through its principal subsidiary in the United Kingdom, Esso, ExxonMobil is one of the largest offshore industry investors (FocusEconomics, 2021). However, investments in the North Sea are managed through 50/50 joint operations with Shell.

ExxonMobil in India and Market Structure Analysis

Incorporated and registered in May 1996, ExxonMobil has its presence in India through its upstream, downstream, and chemical businesses. Its offices are located in Bengaluru, Gurgaon, Mumbai, New Delhi, and the National Capital Region.  The upstream division focuses on providing consultancy and support services ranging from LNG business development and marketing, natural gas and support exploration and production services. On the other hand, the downstream division distributes, sells, and markets Mobil-branded lubricants and specialties (Chart Industries, 2020). Specifically, the downstream business sector has marketed fuel and lubricants in India since 1995 under the Mobil brand through operations such as importation of base oils, lubricant oil branding, packaging, and distribution and marketing. The chemical business is carried out as a service provider to other marketing agents for other ExxonMobil affiliates, facilitating imports and inland sales through distributors and directly to consumers and business analysis since 1986 (The Economic Times, 2021). For instance, in Bengaluru, ExxonMobil has a Technology Center that delivers development support. The business and the technical support centres provide various services for ExxonMobil’s operations worldwide.

ExxonMobil, operating as ExxonMobil Company India Private Limited, entails an Indian non-government firm with a private unlisted firm and a company listed by share. Specifically, ExxonMobil’s authorized capital in India stands at Rs 3500 lakhs and a 55.14429% paid-up capital (Rs 1930.05 lakhs). The last annual general meeting (AGM) for ExxonMobil Company India Private Limited was held on 29 September 2017. The company’s previous financial updates were done on 31 March 2017 as per the Ministry of Corporate Affairs (The Economic Times, 2021).

Comparative Analysis in the Major Macroeconomic Indicators

Indeed, a country’s gross domestic product (GDP) serves as a significant indicator of the national economy’s shape. In the United Kingdom, the gross domestic product (GDP) growth rate has portrayed levelling prospects in recent years after a lengthy period of the effects following the 2008 financial collapse (Monetary Policy Committee, 2020). The average GDP growth rate in the United Kingdom has averaged at 0.58 percent since 1955 and an all-time high of 16.10 percent in the third quarter of 2020, and a record low of -19% in the second quarter of 2020. The country’s GDP’s annual growth rate at market prices has been based on constant local currency. At the same time, the aggregates are determined through factors such as the sum of the gross value added by all resident producers in the economy and product taxes minus any subsidies excluded in the value of the products.

Based on the constant increase in the population from 62.51 million to 67.88 million between 2010 and 2020, the nation’s GDP growth rate has significantly fluctuated from 1.95% to 1.46% in the same period, with an all-time high of 2.61% in 2014. Specifically, the GDP growth rate in 2010 was 1.95%, which declined to 1.54% in 2011, a -0.41% fluctuation. In 2012, the growth rate in the GDP further declined to 1.48%, a -0.06% decline. In 2013, Britain’s economy grew by 2.14%, a 0.66% annual change, marking the fastest pace in approximately three years. During this year, the country’s output increased across industrial sectors such as agriculture (1.4%), production (0.5%), construction (2.5%), and service (0.7%). These rates were followed closely by a substantial growth in the GDP by 2.61%, a 0.47% annual change in 2014; 2.36% growth rate in 2013 (-0.25% in 2015); 1.92% in 2016 (-0.44% annual change); 1.89% in 2017 (-0.03% annual change); 1.34% in 2018 (-055% annual change); and a slight increase of 1.46% in 2019 (0.12% annual change).

However, projections indicate that the economy should recover this year following the potential easement of the Covid-19 pandemic and other monetary or fiscal boosts. The decline in the UK’s GDP growth rate has been associated with numerous factors that include the Brexit disruption that continues to subject the nation to limitations in access to the EU market and further indicates constraints over the growth momentum (Qiang & Kusek, 2020). The catastrophic events associated with the EU’s exit, coupled with the prolonged social distancing measures brought along the Covid-19 pandemic, have posed, and continue to pose, downside risks. Nonetheless, the economy is expected to expand by approximately 6.0% in 2021. Following this trend, the GDP per capita at constant prices between 2010 and 2019 was USD 39,436 and USD 42 330, respectively. Though the trend portrays an increase, the rate has fluctuated exponentially, and similar patterns have been observed between 2020 and 2021 (Trading Economics, 2020).

As portrayed in the table below, UK’s GDP per capita at constant prices increased significantly from 2010 to the subsequent years from $39.436 to $42,039 in 2011 (6.60% annual change). This increase was followed closely by a constant rise to $42,463 (1.01% annual growth rate) in 2012, $43,445 (2.31% growth rate) in 2013, and $47,426 (9.16% growth) in 2014. From 2015 through to 2017, the GDP growth rate per capita at constant prices slightly declined to $44,975 (-5.17% annual change), $41,064 (-8.70% annual change) in 2016, and $40,361 (-1.71% annual decline) in 2017 (Macrotrends, 2021). However, the GDP per capita at constant prices started levelling up in 2018 at $43,043 (6.64% annual change) but later declined in 2019. Between 2020 and 2021, the UK’s GDP growth rate stands at a moderate rate of 1.0% from 16.1% in the third quarter.

Similarly, based on an annual variation of the consumer price index (CPI), the United Kingdom’s inflation rate was approximately 1.74% as of 2019 compared to 2.49% in 2010. (See the table below) (FocusEconomics, 2021). Following this trend, the unemployment rate, based on the active population percentage, stood at 3.8% in 2019, a decline from 5.4% in 2015 and 4.1% in 2018 (Macrotrends, 2021). Similar to the facts that contributed to changes in the country’s GDP growth, the UK’s inflation rate has fluctuated significantly from 2010 to 2020. For instance, since 2011, the UK’s inflation rate was 3.86% with an annual change of 1.36%, but in 2012, the rate declined to 2.57% (-1.28% annual change). This trend continued through the subsequent years with a rate of 2.29% (-0.28%) in 2013, 1,45% (-0.84%) in 2014, and 0.37% (-1.08%) in 2015. In the subsequent years, the inflation rate in the UK portrayed increment prospects from 1.01% (0.64% annual change) in 2016 and 2.56% (1.55% annual change) in 2017 (Macrotrends, 2021). This rate was later characterized by a slight decline to 2.29% (-0.27% annual change) in 2018 and further by 1.74% (0.55% annual decline) in 2019.

Nevertheless, the policy interest rate applied in the United Kingdom averaged 0.75% between 2018 and 2020. Following the 2008 financial crisis, people in the UK reduced their expenditure when the majority lost their jobs, which led to the government cutting interest rates to relatively low levels to support employment opportunities and the people’s income. As a result, the UK government has made it necessary to keep policy interests relatively low over the past few years (Macrotrends, 2021). For instance, between 2010 and the third quarter of 2016, the policy interest rate was regulated to an average of 0.5%, which later declined to 0.25% until the last quarter in 2017. Between the last quarter of 2018 and the first quarter of 2020, the policy interest rate was averaged at 0.75%, which drastically declined to 0.25% and later to 0.1% in the first and last quarters of 2020, respectively. During the same period, the general government’s balance (fiscal balance calculated as a percentage of the GDP) in the UK entailed a deficit of 1.8% of the GDP in the 2018-2019 fiscal year (Macrotrends, 2021).  During the period between 2010 and 2019, the United Kingdom’s unemployment rate fluctuated between 7.79% to 3.85%. Although the rate portrayed a potential increase in 2011 at 8.04% (0.25% annual change), the trend has followed a downward pattern until 2019 (see the table below). Between 2010 and 2012, the general balance declined from -8.7% to -7.3%, which stagnated through to 2013, and continued to decline from -5.8% in 2014, -5.2% in 2015, -4.2% in 2016, -2.8% and -2.7% in 2017 and 2018, and -1.8% in 2019 (US Department of State, 2020). During this period, the balance of payments stood at -172.09 USD billion in 2010, which slightly increased to -170.564 USD billion in 2012, followed by a significant decline to -224.06 USD in 2012. The figures have fluctuated from -115.41 USD billion in 2013 to -222.98 USD billion in 2019 (See table below).  Based on an average period (aop), the UK’s exchange rate has portrayed volatility in recent years amid political turmoil regarding Brexit and debate over when formal negotiations should be initiated with the European Union (Macrotrends, 2021). In 2010, the exchange rate averaged 1.33 GBP per USD, which continued to fluctuate to 1.28 GBP per USD in 2018 (FocusEconomics, 2021).

Macroeconomic Indicator 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
GDP growth Rate 1.95% 1.54% 1.48% 2.14% 2.61% 2.36% 1.92% 1.89% 1.34% 1.46%
GDP per capita at constant prices (in $) 39,436 42,039 42,463 43,445 47,426 44,975 41,064 40,361 43,043 42,330
Inflation rate 2.49% 3.86% 2.57% 2.29% 1.45% 0.37% 1.01% 2.56% 2.29% 1.74%
Unemployment rate 7.79% 8.04% 7.89% 7.53% 6.11% 5.30% 4.81% 4.34% 4.0% 3.85%
Policy Interest rate 0.5% 0.5% 0.5% 0.5% 0.5% 0.5% 0.5% 0.25% 0.75% 0.75%
General government balances -8.7% -7.3% -7.3% -5.2% -4.2% -2.8% -2.7% -2.7% -1.8%
Balance of payments in USD Billion -172.09 -170.564 -224.06 -115.41 -222.98
Exchange rate (% of GDP per USD) 1.33                 1.28

In India, the GDP growth rate was at its peak in 2010 at 16.1%, but over the years, it had declined from 6.3% in 2018 to approximately 4.5% in 2020. This slowed growth depicted a significant reduction in consumption across the private sector, manufacturing, construction, and agriculture activity. Moreover, the stock of foreign direct investment (FDI) in India experienced a decline since 2010, mirroring a similar reduction in India’s private investment (Shroff, Pandey, & Nijhawan, 2021). During this period, the substantial increase in demographics indicated that India should have generated millions of job opportunities annually. According to Guruswamy (2019), the plunge in India’s economic growth since 2010 is based on the change in the economy’s composition. For instance, in 2010, agriculture contributed 17.5% of the GDP, industrial activities brought along 30.2%, while services contributed to 45.4%. Contrastingly, in 2019, agriculture declined to 15.6%, industrial activities fell to 26.5%, and services to 48.5%.

However, based on the informal economy’s large size, India’s unemployment rate rose exponentially to 5.36%, a 0.03% increase from 2018 at 5.33%. This downward trend has averaged at approximately 5% since, in 2010, India’s unemployment rate was 5.64%, which increased to 5.65% and 5.67% between 2011 and 2013 (Macrotrends, 2021). In 2014, the rate continued to decline to 5.61% in 2014, 5.57% in 2015, 5.51% in 2016, and 5.42% in 2017.  Contrary to this pattern, the GDP per capita at constant prices has continually increased from $1,358 in 2010 to $ 2,113 in 2019. This increase has followed an upward trend as in 2012 the GDP per capita at constant prices was $1,444, $1,450 in 2013, $1,574 in 2014, $1,606 in 2015, $1,1,733 in 2016, $1,982 in 2017, and $2,006 in 2018 (FocusEconomics, 2021). During the same period, India’s inflation rate has drastically fluctuated from 11.99% in 2010 to 7.66% in 2019, considering the increase in price across commonly consumed commodities.

Simultaneously, India’s monetary policy interest rate since 2010 has averaged at approximately 4.0%. Still, in 2019 it declined to a 4.40% decline from 6.25% in the previous year, while general government balances during this period have fluctuated from $- 74.62 billion in 2010 to $-78.07 billion in 2019 (Macrotrends, 2021). Similarly, the balance of payments widened significantly to $ 130.5 billion (7.5% of the GDP) between 2010 and 2011 stood at USD -153.5 billion, while the exchange rates in India has continually grown from 44.7125 INR vs. USD in 2010 to 70.91 vs. USD in 2019 on an average period (aop) and as a percentage of the GDP (US Department of State, 2020).

Macroeconomic Indicator 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
GDP growth Rate 8.50% 5.24% 5.46% 6.39% 7.41% 8.00% 8.26% 7.04% 6.3% 4.5%
GDP per capita at constant prices (in $) 1,358 1,458 1,444 1,450 1,574 1,606 1,733 1,982 2,006 2,100
Inflation rate 11.99% 8.86% 9.31% 10.91% 6.35% 5.87% 4.94% 2.49% 4.86% 7.66%
Unemployment rate 5.64% 5.64% 5.65% 5.67% 5.61% 5.57% 5.51% 5.42% 5.33% 5.36%
Policy Interest rate 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 6.25% 4.40%
General government balances -8.7% -7.3% -7.3% -5.2% -4.2% -2.8% -2.7% -2.7% -1.8%
Balance of payments in USD Billion 130.5 -153.5
Exchange rate (% of INR per USD) 44.7125                 70.91

Monetary and Fiscal Policy Analysis and their Impact on ExxonMobil’s Economic Activity

ExxonMobil’s results in each country’s economy are vulnerable to various threats embedded in the global oil, gas, and petrochemical businesses. Most of these threats extend beyond the company’s ability or control and pose adverse effects to its business operations and financial condition. Specifically, the country’s economic conditions in which ExxonMobil operates may lead to its operations’ undesired impacts due to various factors. Among the top factors include the increase in demand for energy and petrochemicals, directly associated with expansive activities and prosperity levels (World Bank Group, 2020). However, when recessions occur or other instances characterized by negative or low economic growth, ExxonMobil’s financial activities and operations directly. Additional components that adversely impact the company’s economic conditions and activities and the country of operation include changes in the rate of population growth, civil upheaval, austerity programs put forth by the government, trade tariffs, public health or security concerns, or fluctuations in the exchange rate on the currency (Shroff, Pandey, Nijhawan, 2021). Their impact occurs due to changes in the demand for energy and petrochemicals.

Thus, these factors are coupled with other aspects that include downgrading debt within the sovereign nation, limitations to accessing debt markets following legal constraints, and restructuring of monetary, fiscal, or political systems such as the European Union.  These components impair the functionality of the financial markets and the nation, in general (Qiang & Kusek, 2020). They collectively pose various threats to ExxonMobil, including predisposing the company to the security risks to its financial assets and its customers and partners in terms of their ability to fulfill their dedication to the firm. For instance, due to the Brexit movement in the United Kingdom, the policy interest rate has since 2018 stagnated at 0.75% due to the ongoing debate and the uncertainty of its monetary, fiscal, and political restructuring economy. Moreover, the outbreak of the Covid-19 pandemic has brought along unforeseen effects to the world by limiting movements, requiring social distancing measures, and locking down businesses within countries. These events have contributed to a continuous decline in the country’s inflation rate (-1.79% by 2019) and an unemployment rate at 76.6% (Trading Economics, 2020).

Similarly, the Indian market is characterized by various factors that may affect ExxonMobil’s economic activities. For instance, when the World Bank anticipates that the rate of inflation may fall below the government’s targeted level (2%), the economy’s growth tends to be slow down. At the same time, the economy faces a recession. As a result, interest rates are strategically reduced (loose monetary policy effect) (World Bank Group, 2020). Alternatively, suppose the world bank anticipates rapid growth in the economy and inflation may exceed the government’s targeted level, increase interest rates to regulate economic growth and further minimize pressure related to inflation, the tight monetary policy effect. In the latter case, an increase in the interest rate leads to a decline in consumer expenditure and investment, resulting in inflation. As of 2019, India’s policy interest rate stood at 4..40%, an increase from 3.4% in the previous year.

Akin to India’s case, the UK has faced similar interest rates, leading to potential threats to ExxonMobil’s economic activities. An increase in the interest rate hinders consumer spending, and investment lowers the inflation rate (US Department of State, 2020). The company’s performance in the economy is predisposed to adverse effects due to inflation and interest rate changes, fluctuations in the currency exchange rate, and other market condition at the local and regional levels.

 

Analysis of the Foreign Trade Policy Instruments and their impact on ExxonMobil’s Economic Activity

Undoubtedly, political and governmental activities can adversely affect ExxonMobil’s economic activities through limitations in the accessibility of its oil and gas resources. For instance, limiting foreign investments in the oil and gas sector leads to a significant boost in the commodities’ price, especially when national governments do not portray any need for capital from external sources (Monetary Policy Committee, 2020). Specifically, a decrease in the aggregate demand leads to the government cutting expenditure (G) and increasing taxes. The increase in taxes reduces consumer spending, and the fiscal policy’s rigidity will cause an improvement in the government budget deficit. However, when faced with situations that lead to an increase in the aggregate demand, the government tends to increase its expenditure and further cut taxes. By lowering taxes, consumer expenditure increases exponentially due to the rise in their disposable income, which, in turn, worsens the government budget deficit and the need to increasing borrowing (Qiang & Kusek, 2020).

Following the Covid-19 pandemic, the UK and India have pursued expansionary fiscal policies to stabilize and sustain operations. As a result, both governments have been forced to cut VAT to boost consumer spending, translating into a significant increase in government borrowing (Trading Economics, 2020). The increased borrowing has lowered the countries’ currency value, leading to fluctuations in the currency exchange rate. For instance, by the end of 2019, the UK’s exchange rate averaged at 1.33 GBP per USD, while India was 70.91 per USD on an average period (FocusEconomics, 2021).

 

Limitations in the Case Study and Recommendations

Although much of the information is available on various sources, it is quite challenging to determine their validity and reliability. Besides, verifying the data presented in these sources is a cumbersome and time-consuming task that requires in-depth analysis and comparison of the information from the country’s or company’s website and physical records. Another limitation arises when these companies fail to voluntarily produce their data in fear that such disclosure may expose competitively sensitive commercial information, leading to violation of non-disclosure laws. To address these challenges, it would be essential to seek the relevant information from the recommended sources that range from government sites, publicly released data from the company, and publications on the recent activities.

By regulating the policy interest and exchange rates, India would serve as a favorable market for ExxonMobil’s operations. It would encourage consumer expenditure based on an increase in foreign direct investment by corporations seeking to tap the firm’s opportunities. Besides, a partnership between the Indian government and ExxonMobil would boost the economy by providing employment opportunities across manufacturing, services, and logistics platforms. This way, both ExxonMobil and India, in general, would benefit from profits reaped, hence making it a hub for increased opportunities within the region and a leading producer and supplier of ExxonMobil products. Similarly, the Brexit initiative could boost ExxonMobil’s operations in the North Sea. The nations within this region, including the United Kingdom, would make independent decisions on the products, foreign investors, and trade partnerships. Consequently, partnering with ExxonMobil would boost its economic activities by increasing its presence within the region, hence increasing profits and productivity.

Conclusion

Despite its success in different countries, ExxonMobil, akin to other international organizations, is faced with numerous challenges characterized by monetary, fiscal, and political changes or restructuring within the country of operation. These changes bring along limitations to the local and foreign expenditure that further culminate in changes in the interest and exchange rates based on the people and businesses’ ability to spend their income on various products. Most fundamentally, government and political factors significantly affect ExxonMobil’s economic activities. They lead to adverse effects that affect operations, limit access to various commodities and services, and put laws and sanctions that prohibit the company from doing business in some countries.

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Appendices