An overview of indian car market - Free Essay Example

Sample details Pages: 16 Words: 4876 Downloads: 10 Date added: 2017/06/26 Category Economics Essay Type Research paper Did you like this example? Despite of the present economic, the Indian Automobile Industry also showed a steady growth during the year 2006-2007. This is evident from the dramatic increase in the turnover of both domestic players and international players. During the fiscal year of March 2006 to March 2007, the Indian automobile industry showed an upbeat performance with each segment showed a record growth. Don’t waste time! Our writers will create an original "An overview of indian car market" essay for you Create order According to Society of Indian Automobile Manufacturers (SIAM India), the domestic sales of Cars have grown steadily over the year 2001-2007. During the year 2001 the annual sales of cars for domestic market was about 6, 75,000 Units, and it has increased dramatically to 13, 75,000 units by the year 2007. Source- Siamindia.com Not only the domestic market, which showed the upbeat trend in the sales of cars, but the export market in the cars have also showed a very positive trend during the year of 2001-2007, as we can see that the number of units exported during the year 2001 was approximately 52,500 and it steadily increased to approximately 2,00,000 in the year 2007. Source- Siamindia.com From the graph shown below, it is evident that the major force behind the sales and export increase in the Indian automobile industry is the considerable increase in the sales of Passenger cars. The sales in the passenger cars also recorded a high rate of growth during the year 2001-20 07 Source- Siamindia.com History of Honda Honda is a leading Japanese company which manufactures world class range of motorcycles and automobiles for  the world market. The Birth of Honda motor company starts with the launching of a Research institute for developing small and efficient internal- combustion engine by an engineer  Honda Soichiro. Later in 1948 it was integrated as  Honda Motor Company  and began producing  motorcycles in 1949. In 1953 Honda introduced a small engine motor cycle code named as C-100 and by the year of 1959. Though, Honda is a pioneer in producing motorcycles, the major part of the companys revenue comes from  automobiles, which the company began producing in 1963, the company also have other major product areas include  farm machinery  and small engines. Honda is a major Japanese exporter to the United States and to other parts of the world. It also has  assembly plants  in a number of other countries and is engaged in joint ventures and technology-licensing agreements with several foreign companies. Honda entered India with a Joint venture with Hero group, who were prominent producers of Hero cycles in India. With Hero group, Honda began to produce and market 100 CC motor cycles, under the name tag of Hero Honda. Hero Honda became the leader in the two wheeler segment in India, after making a formidable position in the two wheeler segment, in December 1995; Honda formed another Joint venture with Shriram group, and formed Honda Siel cars and entered four wheeler market segments in India, with a vision of making world class passenger cars for Indian customers. Internationalization of Honda Uppsala model and Lead Market concept Honda made their first move towards internationalization, by exporting their products to United States of America. In the year 1959 Honda opened their first U.S. production plant in 1979 and has evolved into a company that directly employs more than 25,000 Americans. More than 100,000 workers are employed at authorized Honda automobile, motorcycle and power-equipment dealerships in the United States. Tens of thousands of additional Americans are employed by more than nearly 600 U.S. suppliers from which Honda purchases parts and materials. The pattern of labours and suppliers, chosen by Honda in host country shows Hondas strategy in building a commitment with the Host country. Early contribution of Uppsala model: Johanson WiedersheimPaul 1975; Johanson Vahlne 1977. According to this model there are two modes for a firm to start internationalization; First method of internationalization described by Johanson and Weidersheim-Paul (1975) involves a sequence of steps including a nd establishment chain, At first, no regular export activities are performed in the market Export via independent representatives Sales through Subsidiaries Manufacturing unit through direct foreign investments. Along with the Uppsala model, some of the Japanese automakers also incorporate Lead Country or Lead market method of internationalization. It is a unique model of Internationalization, that a company produce vehicles targeting a lead market, then they modifies and facelift the base model, with the aid of feedbacks they get from the customers of the launched country. This information they utilize for the error detection and to solve the problem. This method of trouble shooting enables the product compatible for launching in another market. Raffee and Kreutzer (1989) describes that lead markets is the country in which a subsidiary of a multy national company takes up the responsibility of a global product and with their RD and innovation; they modify the base or the core model, susceptible to the global market or to another country. While Bartlett and Goshal (1990) argue that lead markets are the first markets that provide stimuli for most of the global products. Kotabe and Helsen (1998) Identifies that Lead Markets are the country in which the process of an innovation takes off. Marian and Thomas (2004) comments that Lead market shouldnt be chosen according to marketing perspective only, it should also reflects the Goal and capabilities of the company. Honda also adopts the same method of internationalization, they produce automobile suitable for a particular target market (Lead country or Lead Market).For e.g. Civic, Accord and CRV were targeted the US markets as the leading country, and then they entered other country with suitable modifications (Product adaptations and marketing communication- adaptations) while Honda city was to Asian markets comprising India, Thailand, Indonesia and Philippines. The market, where the product is first launched is known as Lead Market and the Country and the market which it enters later is known as Lag Market. Market selection method of Honda- Why India? Kumar et al, 1994, describes International Market Selection is a practice of implementing a principle for selecting markets and researching about how much a market can offer, or researching market potentials, grouping them according to their returns and the order of which should be served primarily. While Sayed.H.Rahman (2003) considers choosing a right market to enter is critical in the future success of a firm. Poul and Jesper (1998) argue International Market Selection as one of the major factors which determines the success or failure of an international firm in an international market. From the findings of these brilliant academics, it is clear that the success of a global company is very much depending upon the market or the country which it chooses to serve. As far as Honda is concerned, choosing India, was never a fault or mistake; Major positive and negative aspects of Indian automobile markets are described hereunder; Automobile industry is one of the fastest growin g industries in the India. Each year more than 2 million new automobiles enter on the roads of India and the industry is set to grow further. Automobile industry made its silent entry in India in the nineteenth century. Since the launch of the first car in 1897, India automobile industry has come a long way. Today India stands at the position of the fourth largest car market in the world. There are many factors which attracted the Automakers all over the world to tap in the Indian Auto Market, they are; Political Economical Factor Political factors which influence the global investments are having a stable government, to keep their investment and economy safe. At the moment, India holds a relatively strong and stable government in the region. India was facing a political instability during the year 2004-2009, because of the coalition with Left Democrats. The allied democrats were not ready for the economic liberalization process put forward by Prime Minister Dr.Manmohan Singh. After the national election of 2009, UPA allies got majority, under the leadership of Dr.Manmohan Singh. This stable government condition in India makes global investors to feel confident to invest in India. Until 1991, Indian economy was virtually closed to fresh foreign investment, as the government levied a high import tax on the imported foreign goods. The Monopoly and Restrictive Trade Practices (MRTP) Act or Licence raj passed in 1969 became an obstacle for multinational companies, operating in India to expand their Indian ope rations and during these periods, even Indian subsidiaries of these multinational companies were not permitted, to make foreign exchanges against rupees payment to pay dividends to their particular mother concerns situated abroad. All these stringent rules and regulations in India provided a great opportunity for domestic business to grow. However, when the Indian economy opened up in 1991, a number of leading global automotive companies entered into joint ventures with domestic manufacturers of India and thus started the large-scale production of automobiles in India. The production of automobiles in India is mainly for the domestic customers. Indias Open door policy and the ease in availing new and up-to-date models and the availability of Hassle free Car Loans made Indian Automotive market to flourish (Economic- Watch) Keystone consultancy (US) a subsidiary of LaSalle Consulting Associates-has forecast that India will become the worlds third largest automobile market by 20 30, behind just China and the US. The first and prominent reason for foreign companies to invest in India is because of India m is one among the upcoming economic powers in future, an Emerging Economy. India can be regarded as an emerging market because it is a potential market which promises an extensive growth in future, it has a successful communications and facilities, which facilitates marketing transaction, perfect competition market, the high standard of living, and high per-capita income, development of infra structure It is predicted that, in next few years Emerging markets like India and China will replace the mature markets of America, Europe and Japan as the primary driver of sales growth and will account for 69% of industry and 87% vehicle registrations. Over the few years there has been a significant growth of the Indian market has resulted in the high gross domestic production (GDP). The Annual growth rate of the Indian economy is ranged in between 6-7%. Demographic Factors India is the second largest population in the world with a total population of 967 million peoples. This population is expected to grow steadily and to reach at a total population of 1.2 billion peoples by the year 2040. According a government survey, Youth contributes about 41.05% of total Indian population. A relative amount of youth population is always a target segment for global marketers, as the spending and influencing power of youth is imperative. The rise in the Middle class population is another factor. The rapid economic growth has staged for the fundamental change among the countries consumers. Geographical factor Development of Infrastructure and interconnectivity between cities well developed communication system are a major factor for the inward flow of foreign investment. Market Entry Strategy 6.1. Entering Indian Automobile market Honda Siel Cars India Ltd., (HSCI) was formed in December 1995 as a joint venture between Honda Motor Co. Ltd., Japan and Siel Limited, a Siddharth Shriram Group company, with a vision to providing Hondas latest passenger car models and technologies, to cater the needs of the Indian customers. Honda Siel cars made their debut in Indian market with the world famous model- Honda City in 1997, Honda city has revolutionized the Indian passenger car market and has ever since been recognized as an engineering marvel in the Indian automobile industry. The success of City as well as all its other models has led HSCI to become the leading premium car manufacturer in India. After the success of Honda city, Honda Siel cars introduced a range of products to feed the affluent consumers of India, the products including Honda Accord, Honda CRV, Honda Jazz. With up-to-date models and constant innovations, face lift and re launch in their existing models, Honda Siel cars became the leaders in passenger car segment. In India HSCI made a huge investment of Rs. 1620 crores, further investment of RS. 1000 crore is planned and being currently invested for the coming second plant in Rajasthan. The company has a capacity of manufacturing 100,000 cars. HSCI registered a sales increase of 11% during December 2009. Bruce Kogut (1988) describes a joint venture as a process of incorporating a portion of capabilities or resources of two more companies into a common legal organization 6.2. Entering Small car market If you want to be a major player in the India, in the mass market, small cars are the way to go says Jochem Heizmann cited in reuters.com According to Mr. Koichi Kondo, crowded roads and traffic problems are forcing peoples to buy small cars. So Honda understands the global trend towards automobile selection is downsizing and Fuel conservation. So to raise Hondas presence further in this market a small car like this necessary says Mr.Koichi Kondo Executive vice president of Honda. The successful launching of Honda Jazz marks the entry of Honda Siel Cars into the small car segment, which was once the monopoly of Maruti Suzuki, a Joint venture of another Japan Automobile giant, Suzuki and Indian company Maruti Udyog Limited. Marketing mix of Honda in India Product, Honda jazz in India. A product is anything that is offered to a market for attention, acquisition, use or consumption that might satisfy a want or need (Armstrong, 2008, p500). Honda always incorporates the latest technology in their cars and this always becomes a fair competition with its competitors. Honda introduced the second generation of Jazz in Indian market, which is a face lifted model of the first generation. The Jazzs dynamic performance is achieved by a recently designed and developed four-cylinder 1.2-liter i-VTEC (Intelligent Variable Valve Timing and Electronic Lift Control) engine, featuring Programmed Fuel Injection that delivers maximum output. This engine is specially developed for the Indian Market. This specially designed engine, yielded a fuel economy of 16 KMPL in a test drive conducted by ARAI Since the safety of passengers and pedestrians is a top priority for Honda and all the safety equipment is standard across all variants. Honda Jazz comes with fully loaded with va rious active and passive safety features including ABS (Anti locking breaking system) with EBD (Electronic brake distribution system) Dual SRS airbags and pre- tensioned seat belts. Hondas Advanced Compatibility Engineered body (ACE) and G-CON (G-Force control technology) provide a high integrity survival zone that enhances self protection and better compatibility in collisions with other vehicles. Hondas pedestrian- Injury reduction body design helps protect pedestrians from injury in the event of a collision. This feature is also developed for the Indian market, where there are lots of pedestrian travellers. In response for global call for reducing carbon footprints, the new engine developed by Honda is E10 compatible and has euro IV emission levels. Honda also introduced various kinds of safety features for the safety of both passengers and pedestrians. Pricing and Positioning of Honda Jazz in India Kotler (2008, p639) identified price is the amount of money charged for a product or service, or the sum of the values that consumers exchange for benefits of having or using the product or service. According to Mr. Masahiro Takedagawa, Vice president and CEO, Honda Siel Cars India Ltd, Price should be justified by the value which, in turn, is determined by the costumer Honda Jazz comes with a premium price tag of Rs.7, 00,000/- plus. Though Honda jazz is completely manufactured in India, with the sourcing of 70% raw materials from local suppliers, the price of Rs.7, 00,000/- is because, Honda jazz is equipped with the latest and up to date technologies for the Safety of passengers and pedestrians Honda jazz is positioned at a segment of Premium Hatch Back, with its competitors as Skoda Fabia, Suzuki Swift. Honda faced a challenge during positioning of Honda Jazz. The Jazz itself qualifies as a small car (in India) by its virtue of size and Engine power, but its priced at Rs.7, 000, 00/- plus which valued than some midsized Sedan. In Thailand it is high positioned than City. Since Honda city is the flagship product of Honda in India, it became a hurdle for Honda Siel Cars to promote Honda Jazz over Honda City. The Ex showroom price of Honda jazz at the capital city of India, New Delhi is from Rs.6,93,000 to Rs.7,33,000. Prior to its launching the price tag of Honda Jazz was about Rs.8,20,960/- which is near to or more than the widely accepted Honda City, the sedan product of Honda. The base model of Honda city 1.5 S Manual Transmission cost about Rs.8, 40,000/- (Ex. Showroom Delhi). Honda dealt with the problem by making some slight changes in its engine. Honda compromised with the global engine of Honda Jazz, they lowered the engine capacity to 1.2 L i-VTECH, while majority of other markets enjoy Honda Jazz with 1.5 L i-VTECH. This compromise with the engine power has made Honda jazz eligible for a reduction of 12% in excise duty, with Exci se duty incentive of 12% Honda managed to position the Honda Jazz below its best seller sedan Honda City Honda managed to price Honda jazz in between Rs.6,98000 and Rs.7,33000. As a result of new engine, Honda Jazz became Economical in fuel consumption as well. Place According to Kotler and Armstrong, (2008), a Place is described as the location, where a consumer can obtain the service or a product, which a firm offer. Honda Siel Cars India Ltd. distributes their cars through their network of dealerships along the nation. Since Honda Products comes under premium range, they maintain state of the art Showrooms to uphold the premium value of Honda products. HSCI has already expanded and strengthened its dealer network in preparation for the launch of the Jazz. Distribution of the Honda Jazz is done with the aid of companys vast distribution network of 105 authorised dealership facilities, across the country. This network is likely to go up to 112 facilities by the end of the current financial year. Promotion Of Honda Jazz in India Kotler and Armstrong, (2008) describes the marketing promotion as a set of information about the product, which is delivered to customer to induce sales or a positive response. Honda is always unique in marketing communication. Considering the advertisement Honda, they were very careful and precise in their advertisement. Honda always projected their image as the most important thing. In their advertisement, they project the latest advanced technology, eco friendliness the brand name they project through the advertisement is Honda, than the Product. Honda promotes their products in majority through print media compared to the other players. Majority of the advertisement comes in national daily and magazines because they believe; it could educate the target customers in a better way. They promotes their product through the Honda websites as well, in the company website, Honda gave the awards and other honours they received in their excellence. Compared to Hondas Competitors , Honda was never into the aggressive promotional activities but the company always tried to maintain the quality and the created brand image by providing the best customer service Standardization V/S Adaptation of Honda Jazz in India Hamel and Prahalad (1985) argued that markets have become so homogenized that firms can market identical products and services across the globe through standardization. Standardization of the market is a firms movement towards homogenization of the market and to save cost of alteration (Cavusgil, Zou, Naidu, 1993) Kotler (1986) has advised the marketers not to be ignorant or biased while implementing standardization. While Boddewyn, Soehl and Picard (1986) has criticised that the social, political and cultural aspects are different across the borders and hence, the marketing program should be an adapted one to cater the diverse local situation and condition of the host country. Buzzell (1968) said, since the marketing program is entirely depending up on the local scenario of the market, so it should be adapted according to the local condition. There are many internal factors which determines the degree of standardization or adaptation a company should make in a market (wind, 1986) Product Adaptation and Standardization Honda introduced fairly standardized product, when we look at the exteriors periphery of Honda Jazz introduced in India. We can see the degree of standardizations in the dimensions and specification of the car they introduced in Indian market. However, Honda made a remarkable Product adaptation for the Indian market. In Japanese and some of the other European market the first generation of Honda Jazz is equipped with a 1.5 Litre i-VTEC  engine, while in India the second generation Honda Jazz comes with a specially launched 1.2 Litre i-VTEC engine, specially designed for the Indian market. This engine enables the car to be economical in fuel consumption without compromising much of power. Honda incorporated incredible spacious interiors for the Indian customers, who prefer lots of space for comfort and to store things inside their vehicles. Another important adaptation Honda made in Jazz for Indian market is, they only introduced manual transmission cars for the Indian market while other markets like Japan and Europe has its i-Shift transmission Model as well. In India, Honda kept the principle of approach of man maximum and machine minimum in designing, which enables maximum space for the passengers and reduce the space consumed for machine components Adaptation and Standardization of the Marketing Communication In India Honda made a standardization of their marketing communication up to an extend by avoiding celebrity endorsement. In India, Honda projected their brand image as the important thing for other models, while they made adaptations in conveying marketing message For Honda Jazz in Indian market, Honda made a remarkable adaptation, by giving a Slogan only one life, why so serious? with this slogan, they are clearly targeting the Jazzy youth of India (NDTV, Car and Bike Show), which constitutes major part of Indian population. Through their commercials they also demonstrate the space they incorporated inside the cars, especially for family person, who have to do multy tasking as a professional and a family person same time. Honda Jazz also came with another slogan of Magic Seat which stands for incredible storage space inside the car. According to the slogan they convey to the customers that with Magic seats, you can stuff your Jazz with anything you want India is a country of f estivals, so the promotions of Honda are a bit adopted for catching the religious consumers of the market. Honda for the first time introduced a great Honda fest during Dussera festival. Honda introduced win a car contest for the costumers of India. Costumer who purchase during the season of Dussera, will be eligible for participating in the contest. The grand price for the contest was to win a Honda car. Customers can also win accessories for free during their purchase on the festive season. And it was a successful adaptation to catch the customers during the festive season. Future of Honda in India Hondas new family car based on the Honda new small car concept unveiled in Delhi and will hit the showrooms in and India and Thailand by 2011.Honda Identifies India as the launch pad for its global small car which will debut during the next two to three years. The car, code-named 2CV, will have a maximum engine size of 1.2 litres to meet requirements for lower taxes and is expected to also be priced below 500,000 rupees. This car will be positioned under Honda Jazz and the vehicle is being developed for India as the lead country, it will enter other country. Conclusion So to sum up, we can say that the introducing up to date model and technology in India and their successful positioning and flexi factory network (Andrew Mair, 1994) and the glocolization process implemented by Honda, along with successful adaptation and standardization, for the Indian market made the Honda Siel Cars India Ltd. To overcome the marketing challenges, it faced during the launching of Honda Jazz in India. Refrences Akah Ishmael P. 1991, Strategy Standardization in International Marketing: An empirical invesgation of its degree of use and correlates. Journal of global marketing, 4(2) , pp 39-62 Andrew Mair (1994),Hondas Global Flexi Factory Network, International Journal of Operations Production Management, Vol. 14 No. 3, , pp. 6-23 Armstrong, G et al (2009) Marketing an Introduction, Prentice Hall, UK. 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And Jachimsthaler,E.A,(1994), An international criteria approach to identifying potential foreign markets, Journal of international marketing, 2(1),pp.29-52 Levit-Theodore- 1983, Globalization of markets, Harward business review, pp, 13-15 Marian Beise and Thomas Cleff (2004), Assessing the lead market potential of countries for innovation Project, Journal of International Management, 10 (4), pp 453-477 Poul.H.Anderson and Jesper Strandskov, (1998), International Market selection: A cognitive Mapping Perspective, Journal of Marketing,11(3), p.p. 65-84 Syed.H.Rahman,(2003),Modelling of international market selection process: a qualitative study of successful Australian international business, Qualitative Market Research: An international Journal, 6(2),pp.119-132 Wind, Yoram, 1986 The myth of globalization,  Journal of Consumer Marketing, Vol. 3 pp.23-6. 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Information about Indian Car market in future, Economy Watch, Available at; https://www.economywatch.com/business-and-economy/automobile-industry.html Accessed on December 28th 2009. Information about the Indian Car Industry, Indian Express daily, Available at; https://www.expressindia.com/news/fullstory.php?newsid=59286 Accessed on December 28th 2009. Information about the automobile industry in India, Automobile maps of India, Available at; https://automobiles.mapsofindia.com/ Accessed on December 30th 2009 Information about the launching of Honda Jazz in Indian market, NDTV, Available at; https://www.ndtv.com/news/videos/video_player.php?id=1125975 Accessed on January 6th 2010. Information of Honda Production,The Hindu Business report, Available at, https://www.blonnet.com/2009/06/21/stories/2009062150770200.htm Accessed on January 7th 2010. 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Nursing Assignment - Case Study analysis and Lecture Notes

Question: Case Study 1. Scenario: A 78 year old Greek lady, Anastasia Kyrillos, has recently been transferred to the rehabilitation unit following a left sided Cerebro Vascular Accident (CVA). She has right sided hemiparesis, but has regained some function since the CVA occurred two weeks ago. She uses a wheelie walker (with a one person assist) to transfer from her bed to the chair and to walk short distances. Communication is difficult as Anastasia doesnt speak English and, secondary to the left sided brain injury, she has developed aphasia. Her family reports that she understands them very well but has difficulty expressing herself. Anastasia was living in a flat attached to her daughters family home until the time of the CVA and hopes to return there following rehabilitation. Medically, Anastasia had a history of poorly controlled hypertension which resulted in the haemorrhagic stroke. Currently her Blood Pressure (BP) is stable; she takes anti-hypertensive medication and requires regular checks of her BP. She has osteoporosis, which was diagnosed 10 years ago after she fell and fractured her right hip. She also has Diabetes Type 2 and takes oral hypoglycaemic medication. Anastasia has stress incontinence of urine and wears an incontinence pad during the day. Her bowel function is normal. 1. What activities of daily living will Anastasia require assistance with? Provide details of each. 2. What cross cultural communication strategies will nurses need to implement for Anastasia? 3. What are the actual and potential nursing care needs of Anastasia? 4. What are the potential health complications that might occur as a result of each of Anastasias current medical conditions? Answer: Case Study 1. 1. The assistance for Anastasia includes a nursing aide, who can help her to transfer from her bed to the chair and to walk short distances. This is because Anastasia uses a wheelie walker after her CVA. Anastasia does not speak English so she should be assisted with an interpreter which can help her as well as her health care professionals to ease the process of communication. Anastasia is also suffering with an acquired language disorder because of CVA (Code, 2012). Therefore, a multi-disciplinary team should work together to improve her condition. The team includes physician, physiotherapist, speech-language pathologist, social worker and a clinical neuropsychologist. 2. The cross cultural communication strategies that nurses need to implement for Anastasia are: slow and clear communication, clarification, frequently verify for understanding, avoid typical idioms while communicating, avoid jargons, focus on specific meaning of communication, efficiently select the communication medium, give proper instruction and maintaining patience (Jirwe, Gerrish and Emami, 2010). 3. The actual and potential nursing care needs of Anastasia includes thorough monitoring of her blood glucose level as she is a patient of type II diabetes. Anastasia also had a history of poorly controlled hypertension that resulted in the CVA (Lammert, 2008). Therefore, her blood pressure needs to be monitored regularly. She is also under the administration of antihypertensive drugs. Monitoring helps the nurse to manage her BP. Proper monitoring also helps in reduction of the risk associated with further CVA. Anastasia has osteoporosis and also had a fall and fracture. So, the nurses should always take care about her support while allowing her to move from one place to another. This will reduce the chance of further fall. Anastasia wears incontinence pad, so a nurse aide is necessary who can take care of her hygienic factors. 4. Various potential health complications might occur as a result of each of Anastasias current medical conditions. Anastasia is hypertensive and diabetic. Both these reasons are harmful enough to make her condition worse. Higher blood pressure might lead her to another chance of CVA (LeMone and Burke, 2008). If osteoporosis is left untreated it increased the risk of falls and fractures, vertebrae fracture can cause her to compress, and curving of spine can takes place and result in a stooping posture, termed as kyphosis and ultimately loss of mobility because of osteoporosis. If stress incontinence of urine is left untreated it can affect the kidney, bladder and the urinary tract in terms of forming infection. If aphasia is left untreated, Anastasia might develop a serious speech complication. Question: Case Study 2. Scenario: A 22 year old male client, James Moorland, was involved in a motor bike accident 3 weeks ago and sustained a compound fracture to the right distal femur. He has been in the orthopaedic ward for 3 weeks and has undergone 2 operations on his leg; the first was to reduce the fracture using internal fixation (plate and screws) and to surgically scrub the compound wound, the second was a delayed primary closure of the wound. It is one week since the delayed primary closure, and his bandages have been taken down. The wound is beginning to break down and there is a purulent, offensive smelling discharge present at the suture line. Swabs taken confirm the presence of methicillin-resistant staphylococcus aureus (MRSA). James has been placed in an isolation room and the hospital infection control team have been notified. Medically, James has no co morbidities; he has had no previous surgery. He is marginally underweight, with a Body Mass Index of 18. James has a history of poor nutrition, is a heavy smoker and regularly consumes alcohol. James is the third client in the ward to develop MRSA in their wound in the last month. The outbreak of infection is ward specific and no other surgical cases from other wards have cases of MRSA. 1. Discuss the means by which MRSA could be spread in a health care facility. Include in your answer the measures that should be taken to prevent this.2. What risk factors may have contributed to James developing a nosocomial infection? 3. What strategies should be implemented to minimise infection risks to the remaining surgical clients on the ward? 4. Considering the workplace policies and procedures, what are the documentation and reporting requirements for nosocomial infections? 5. James is non-compliant with dietary supplements (i.e. vitamins and Sustagen drinks). What nursing care strategies should be implemented to improve James nutritional status? Answer: Case Study 2. 1. MRSA can be spread in a health care facility by various means. In hospitals MRSA can be spread from one patient to another by the hands of health care staffs. The gloves they wear may become contaminated with MRSA when they touch a patients wounds during dressings or devices like intravenous tubing. Patients who are suffering from severe weakness in immune system because of any medical condition or treatment are the most probable to get affected with MRSA, frequently and rapidly (Nimmo and Coombs, 2008). The other chances are close proximity to already affected health care staff or patients. Prolonged stay in hospital is one of the causes of spreading of MRSA infection. The infection can also spread if contaminated waste materials are not disposed in an appropriate disposal box. If one touches these contaminated products like fluid waste, used needles, there is a chance that the person can spread MRSA to other individuals. To prevent spread of infection, health care professionals should maintain proper hand hygiene while working within the health care set up. They should also use use and throw gloves between patients. 2. James has undergone 2operations; the first was internal fixation and the other one delayed primary closure of the wound. James might have developed a nosocomial infection because he might have got affected with the ward specific infection (Bennett et al., 2005). The surgical instruments used in James surgery, might not have been sterilized properly. 3. Strategies need to be implemented to diminish the MRSA infection risks to the remaining surgical clients on the ward. This can be achieved by implementing inspection and screening of patients, staffs, patient isolation and grouping, obliteration of MRSA carriage. The health care personnel have the responsibility to implement guidelines rests with the higher management of the institution. As it is proved that MRSA is mainly transferred from hand, therefore, guidelines associated with hand hygiene should strictly be followed by the health care personnel. For instance, maintaining hand hygiene before entering and after leaving critical care wards, open rooms and isolation rooms used for grouping MRSA cases. 4. Documentation and reporting requirements can be considered as one of the important aspect under the infection control policy. Documentation is essential for all reprocessing of re-usable equipments and instruments and for the sterilizers in accordance with the guidelines. Not only the instruments but any kind of nosocomial infection outbreak needs to be reported and documented for future evaluation, if necessary and also to maintain a record (Gosbell et al., 2006). MRSA infection needs to be reported too Infection Control and the record can only be maintained accurately through documentation, including communication with other health care staffs and families. If patients need immunization, then vaccine should be arranged by ward medical staff on medication chart. 5. James is slightly underweight with poor nutrition. He is a heavy smoker and regular drinker. In this situation nurses should take care of his nutritional status. James is unwilling to receive dietary supplements. Therefore, James needs to be referred to a dietician who can structure a protein rich diet for James. It is the nurses responsibility to make James understand that drinking and smoking have killing effects on the system and he should not entertain these habits in order to maintain a good health and wellbeing. James had undergone a severe fracture that might affect his bone, so his diet should include calcium rich foods. Question: Case Study 3. Scenario: A 53 year old client, Gordon Freemason, was attempting to clean his gutters at home and fell from a ladder. He sustained undisplaced fractures to his L4 and L5 vertebra, as well as, a depressed occipital fracture to his skull. Secondary to the skull fracture, he suffered an extra dural bleed. He went to surgery for an evacuation and drainage of the extra dural bleed, and his occipital fracture was surgically elevated. He was monitored for further intracranial bleeding for 12 hours post-operatively in the Intensive Care Unit (ICU) before being transferred to a ward. He is on strict rest in bed and pressure area management involves regular log rolls. Gordons Glasgow Coma Scale is 14/15, and he is alert and orientated. He has significant pain from his lumbar fractures and is receiving morphine via continuous infusion in the form of patient controlled analgesia (PCA). This is supplemented with regular 6 hourly paracetamol. He has intravenous fluids running. Gordon is an asthmatic and takes ongoing preventative inhalers. He had an upper respiratory infection prior to his fall and had been taking antibiotics for it. He is obese, with a body mass index (BMI) of 32. Gordon has a history of depression, which he manages with counselling; he is not currently medicated for his depression, but has been expressing negative thoughts and has spoken of committing suicide if he cannot regain his independence. He lives at home with his wife and their 3 teenage children. Gordon is under the care of the neurosurgical and orthopaedic teams. 1. How might Gordons pre-existing medical conditions be affected by his fall and subsequent hospitalisation? 2. What are the actual and potential risk factors for Gordon following surgery? 3. Health care providers have a no lift policy in terms of workplace health and safety and manual handling. What methods could be used to lift Gordon off his bed in order to provide back care and change his bedding? 4. Healthcare providers are governed by legislation regarding medication administration. Hospital policy and procedures reflect that legislation. Gordons morphine infusion is running out and a new bag of morphine and saline needs to be made up. What schedule of drug is morphine and what are the seven rights of drug administration that need to be considered? 5. Considering that Gordon will be required to walk with a frame until his mobility and motor function return, what discharge planning needs will Gordon have if he is to return home? Answer: Case Study 3. 1. The pre-existing medical condition of Gordon includes his asthmatic condition. Prior his fall he had an upper respiratory infection too and was under antibiotic administration. Gordon takes preventive inhalers. His fall might affect his asthmatic condition. The increase pain because of the fracture in his lumber region can augment the suffering of perspiration. Another issue could be his obesity. Because of the fall he is strictly in bed rest and requires pressure area management. Obesity can affect the application of log roll to turn Gordon while maintaining spine alignment. Gordon has a history of depression, which has been managed by counseling but because of his severe fall he cannot attain the regular counseling and that might augments his negative thoughts like committing suicide. 2. The actual and potential risk factors after surgery may include the possibility of brain herniation. Intracranial hemorrhage increases the intracranial pressure and can damage delicate tissues of the brain or can limit the supply of blood to the brain. Severe increase can cause brain herniation. Being obese there is a chance that Gordon might develop a pressure ulcer if his pressure area is not under proper management. His occipital fracture was surgically elevated so a chance of infection in surgical site can be considered as a potential risk factor. Additionally background infusion can diminish inherent PCA safety (Lintzeris, 2006). Respiratory depression can takes place if background infusion is applied. 3. Methods to lift Gordon off his bed could include application of log roll to move him maintaining his spine alignment; bed-stick which could be attached to the side of the bed and allows him to sit up; overhead bar that helps Gordon to lift and reposition himself. 4. Morphine comes under schedule II drugs. The seven rights of drug administration includes right patient, right medication, right dose, right route, right time, right documentation and right reason. Right patient includes check patient name and the order, right medication includes proper check for medication label and order, right dose confirms dosage appropriateness using existing drug reference, right route confirms if the patient receive medication y ordered route, right time includes confirmation when last dosage was administered, check correct time and frequency of ordered medication (Dubut de Laforest and Farrere, 2010). 5. Gordons discharge planning requires employment of a nurse aide at Gordons residence. This is because if Gordon is walking with the help of a frame there is a possibility that Gordon can lose his balance so a nurse assistant should be always there by his side during his movement unless his motor function returns. Gordon should be referred to a physiotherapist to resume his physical activity. The physiotherapist can train him with light aerobic exercises, which can also help to control his obesity. His discharge plan should also include continuation of his depression counseling. Question: Case Study 4. Scenario: A 30 year old woman, Louise Young, has returned to the ward following laparoscopic surgery for a ruptured appendix. On return, her observations are temperature - 38.9 C, respirations 28, pulse- 112 and BP - 140/75. She has four abdominal incision sites and each is covered with a transparent occlusive dressing. The wound sites are intact and each is oozing slightly. Louises abdomen is slightly distended and her estimation of her pain level is 8/10. Louise has an intravenous line in her left cubital fossa (inside elbow). She is receiving maintenance dextrose and saline fluids at 125mls/hour. She is to take nil by mouth, and has a nasogastric tube on free drainage. Louise has received intravenous fentanyl in recovery, and has an order for intravenous morphine on the ward. Half an hour after her return to the ward, Louises condition has deteriorated. Her observations are temperature - 40.1 C, respirations - 36, pulse- 160 and BP 100/55. Her abdomen is tight and distended. Her level of consciousness has deteriorated, she is only able to be roused if her shoulder is shaken and she is spoken at loudly. 1. When Louise initially returns to the ward, what are the priorities of care for her (keeping in mind observations, dressings, analgesia and any other care she may need on her return from theatre)? 2. What are the immediate actions that need to be taken upon finding Louise in this state of deterioration? 3. What might be happening to Louise? 4. What action should be taken if Louises condition deteriorates further? Answer: Case Study 4. 1. After returning to the ward Louises priorities of care includes thorough observation, dressings and analgesia. Half an hour after returning to the ward her temperature and respiration rate increased. Her pulse rate increased and blood pressure dropped. She has four abdominal incision sites which were oozing slightly, so care is utmost important in this case to avoid surgical site infection. She was in tremendous pain, so the health care professionals should monitor and control her intravenous analgesic dose along with saline. During the operation her BP was excessively high but after transferring her to the ward her BP reduces, so the responsible nurses should properly monitor her blood pressure level. 2. The immediate actions for Louise may include additional support of oxygen mask to support her breathing. Her tachycardia condition is thought to be because of her medical illness, this should be managed with proper medications. The distended and tight abdomen might be because of necrotising fasciitis or gas collection within the abdominal muscles. 3. Louise might be suffering from Necrotising Fasciitis. Necrotising Fasciitis after laparoscopic appendectomy can takes place in certain cases (Raghavendra, Mills and Carr, 2010). This condition includes abdominal pain along with tightness feeling and swelling of abdominal wall. It is also considered as unusual complications. Necrotising Fasciitis is considered as a disease condition of quickly spreading infection, generally located within the fascial panes of connective tissues. 4. If Louises condition deteriorates further the responsible care providers should communicate her health condition to the doctor in order to understand if Louise needs any change in medicinal administration. Louise received IV fentanyl and has ordered for IV morphine. In this case the nurse should communicate with the doctor whether to follow the same or needs any alteration. Louises level of consciousness has deteriorated so the nurses should be able to record timely observation and if any abnormality is identified. References Bennett, N., Boardman, C., Bull, A., Richards, M. and Russo, P. (2005). A statewide smaller hospital nosocomial infection surveillance program: The first report, Victoria, Australia.American Journal of Infection Control, 33(5), pp.e176-e177. Code, C. (2012). Apportioning time for aphasia rehabilitation.Aphasiology, 26(5), pp.729-735. Dubut de Laforest, J. and Farrere, C. (2010).Morphine. New York: Harper Perennial. Gosbell, I., Barbagiannakos, T., Neville, S., Mercer, J., Vickery, A., OBrien, F., Coombs, G., Malkowski, M. and Pearson, J. (2006). Non-multiresistant methicillin-resistant Staphylococcus aureus bacteraemia in Sydney, Australia: emergence of EMRSA-15, Oceania, Queensland and Western Australian MRSA strains.Pathology, 38(3), pp.239-244. Jirwe, M., Gerrish, K. and Emami, A. (2010). Student nurses experiences of communication in cross-cultural care encounters.Scandinavian Journal of Caring Sciences, 24(3), pp.436-444. Lammert, E. (2008). The Vascular Trigger of Type II Diabetes Mellitus.Exp Clin Endocrinol Diabetes, 116(S 01), pp.S21-S25. LeMone, P. and Burke, K. (2008).Medical-surgical nursing. Upper Saddle River, N.J.: Pearson/Prentice Hall.

Symbolism In The Crysanthemums Essays - The Chrysanthemums

Symbolism In The Crysanthemums Symbolism in The Chrysanthemums At first glance John Steinback's The Chrysanthemums' seems to be a story of a woman whose niche is in the garden. Upon deeper inspection, the story reveals strong symbolisms of children, vulnerability, and connection--being the most important, of the main character. Elisa Allen is the main character who is at her strongest and most proud in the garden and weakened when she becomes vulnerable and loses her connection to the outer world. Elisa shows a new aura of confidence when she makes this connection to a peddler, who also is the cause of her realization of reality and her crying. The chrysanthemums symbolize Elisas children. She tends her garden and handles the chrysanthemums with love and care, just as she would handle her own children. Elisa is protective of her flowers and places a fence around them; she makes sure that no aphids, no sowbugs or snails or cutworms are t here. Her terrier fingers destroyed such pests before they could get started ( 221). These pests represent something that harms the flowers, and she removes them before they can harm her children. The chrysanthemums are symbolic of her children, and she is very proud of them. She is happy and pleased by her ability to nurture the chrysanthemums as she would her children. Elisa's vulnerability is shown through her experience with the peddler shows an interest in the chrysanthemums when he describes them as a quick puff of colored smoke (223). By admiring the chrysanthemums, he figuratively admires Elisa Allen. The peddler gives Elisa a connection that she can't do with anyone else. By giving him the pot to put the chrysanthemum seedlings in, she gives him the symbol of her inner-self. She begins to feel hope as the peddler leaves. She dresses up nice and prepares for her night out with her husband. This preparation process symbolizes that she is preparing for a change in her life. Her washing and dressing is symbolic of her transition. Tearing off her soiled clothes and flinging them into the corner, she scrubbed herself with a little block of pumice, legs and thighs, loins and chest and arms, until her skin was scratched and red. This is symbolic of Elisa coming out of her old being, releasing a newness she had become to know. She tightened her stomach and threw out her chestShe put on her newest under-clothing and her nicest stocking and the dress which was the symbol of her prettiness. She worked carefully on her hair, penciled her eyebrows and rouged her lips. All of this is brought about because one man took interest in her private pleasure-the chrysanthemums. Her connection with the peddler has made her come out of the fence that she is so used to being inside of. She is free and she likes it. Elisa has seemed to undergo a complete metamorphosis from being an unsocial housewife to a confident woman when she makes this connection. She boasts, I am strong. I never knew before how strong. Unfortunately, at the conclusion of Steinbeck's short story, Steinbeck has her fall right back into the rut she so despised. When she realized that the peddler had dumped out the seeds and soil, and she comes back to reality and turned up her coat collar so her husband could not see that she was crying weakly-like an old woman. She is crushed and all that she had gained that day was taken away. This story expresses how easy it is for someone's hopes and confidence can be crushed if it is given into the wrong person's hands. The title The Chrysanthemums is used to point out that Elisa's chrysanthemums are an image of her. The image reflects how she feels towards children through her flowers, what her vulnerabilities are, and how she uses them to make connections. Elisa accomplished what she always wanted, but in the end a careless peddler took that away. She returned to being her old self, the self that lived within her own garden and fence. Bibliography Works Cited Steinback, John. The Chrysanthemums. Literature: An Introduction to Fiction, Poetry, and Drama. Eds. X. J. Kennedy and Dana Gioia. 8th ed. New York: Longman, 2002. 245-253. English Essays