Business policy and strategy

Summary of McDonald’s strategies and performance

The McDonalds Corporation is a successful global restaurant that operates chains around the globe. The organization has employed global expansion and effective management strategies to enter new markets and gain a share of the diverse, fast food market. It is clear that McDonalds has achieved this massive success. The business has established best practices in the global food industry. However, it has also experienced international growth challenges trends in the recent past. These factors have seen the company perform poorly in its different businesses in both local and foreign nations. (Mourdoukoutas, 2013)

One of the strategies employed by McDonalds is the creation of both customer and brand loyalty for its products and services. Right from the beginning, the founder, Ray Kroc ensured that the French fries customers bought in one restaurant would be similar to another McDonald restaurant by developing a sophisticated operating and delivery system. He proved himself an industrial pioneer who revolutionized the American restaurant industry by imposing discipline on the production of milkshakes, hamburgers, and French fries. The consistency made McDonald’s the brand name that defined American fast food. In the restaurant industry, the McDonald’s is well known for high-quality foods and services evident in the quantity of customers they serve. The making of a uniform and consistent product for customers is one of the most important aspects of McDonald’s success. (Beef Central, 2015)

Irrespective of where customers purchase their products, once they see the ever-present “golden arches” they know exactly they are expected to get. McDonald’s Mission Statement has helped the business to focus on what really matters both to itself and to stakeholders. It has acted as a guide to strategic and routine operational decisions. In addition, it represents the glue that binds all the franchises under the organization together. Another strategy employed by McDonalds is rapid expansion. Right from the beginning, McDonalds expanded by franchising. By 1960, more than 200 McDonald’s outlets were operational. McDonald’s Corporation has been recording declining sales and profits both in its local and foreign businesses. On the other hand, competitors have been formulating strategies to attract more customers to their business. In 2015, McDonald’s reported 30% drop in profit and 11% decrease in revenue for the first three months of the year. It announced hundreds of store closings. The company has been trying to fix its problems particularly in the U.S market that generates 40% of its profit. It is simplifying its menu to appeal to its customers. It is testing all-day breakfast and has slowed down service and focused efforts on reducing errors in orders. (Mourdoukoutas, 2013)

The reality is that McDonald’s recent performance has been poor. In 2015 first quarter, the company recorded US$5.6 billion in global revenue down from $6.7 Billion in 2014 first quarter. The net income recorded amounted to $ 811 million down from $1.2 billion in the year 2013. Part of the business expenses arose from charges linked to restaurant closures. In the US and Canada, 220 restaurants were closed as well as 130 in Japan. The company is expected to close other 350 restaurants worldwide to avoid further loses. McDonald’s largest division in the United States saw a decrease in sales of up to 2.6% reflecting low customer traffic and negative sales amidst high competition. (Mourdoukoutas, 2013)

The operating income decreased by 11% as a result of weak sales and restructuring and closing activities. In its Europe’s division, the business experienced a decline in sales of 0.6%. First quarter operating income decreased by 20% partly as a result of currency and inflation pressures in Russia and continuing macroeconomic pressures facing much of Europe The business’s Pacific, Asia, Middle East and African divisions saw first quarter sales decrease by 8.3%. Asia region had a prolonged impact of consumer perception issues particularly in Japan over food safety breaches. The operating income in these regions decreased due to restaurant closing in response to poor performance.

Understand Legal and Ethical Issues of Assisted Suicide

1. Discuss the legal rules and regulations on assisted suicide: one state legalizes the assisted suicide, and the other state does not.

In the United States, Oregon and Washington have legalized physician-assisted suicide. This law established by states provides citizens in the state with a right to assisted suicide commonly known as ‘death with dignity.’ In these states, physicians are empowered to aid patients to end their life and have been provided with a legal excuse to a charge of assisted suicide. The law in these states gives specific conditions when and under what circumstances a patient can be allowed to get assistance to end their life. Some of the requirements include that the patient is expected to die within a specified period and that the procedure must follow certain consent guidelines.

In states where there is no law legalizing physician-assisted suicide, an individual or a physician is guilty of promoting suicide attempt when they intentional leads to or assists another person attempt suicide.

2. Discuss the legal issues on assisted suicide (e.g., 2nd-degree murder).

The legal issues arising from physician-assisted suicide is that doctors can be charged with second-degree murder as they would be killing or aiding in the death of a patient intentionally. The legal perspective of homicide is described by the act of bringing about their death or assisting in ending their life, which is the act of assisted suicide. In care facilities, a legal issue arises when a doctor whose responsibility is to do good, aids in the death of a patient who requests assistance to commit suicide. The doctor may be charged and found guilty of assisting another person to commit suicide.

3. Discuss the ethical issues of assisted suicide (e.g., right to die).

Various ethical issues arising from traditions of nursing and medicine have led to opposition of assisted suicide by nursing and medical organizations. The patient’s in care facilities have a right to know their prognosis to make decisions concerning the implementation of life-prolonging treatment. Although patients have a right to make a decision about what they want, the ethical issue that arises is whether they are mentally competent and can make properly informed end of life decisions about their condition. Also, an ethical issue that arises from a patient who has a right to die and seeking to end their life since they are suffering is whether the suffering should be viewed according to the patient’s view or considered in other people’s perspective. An ethical issue on assisted suicide on an individual who has a right to die is whether the approach used is widely acceptable.

4. Shall the person (i.e., a family member) be charged a crime (e.g., murder), who has provided any kind of assistance to another person’s suicide?

A family member who provides any kind of assistance to another individual so as to assist end their life is guilty and may be charged with a crime of manslaughter. The crime is that the person purposely aids another commit suicide regardless of whether the patient was willing or made own decision to end their life. The kind of assistance may include giving advice on how to end life, giving a book that provides guidelines on suicide or even providing pills or medicine or other physical means that causes death.

5. Your feedback and solutions to the issues of assisted suicide, legal and ethical

The subject of assisted suicide whether by a family member or an organization or a physician raises sharp contrasting opinions. Individuals commit or have thoughts of committing suicide for various reasons that range from ending the suffering caused by terminal illnesses or other problems. Governments and states should formulate and enforce laws that prohibit assisted suicide without proper guidelines or advice. The individuals seeking advice on assisted suicide or those who want to commit suicide should have adequate knowledge of the outcome of their actions. Federal and state government should also increase assistance to patients who are suffering or have pain due to some illness.

Telenursing

Introduction
Telenursing is the utilization of technology to conduct nursing practice and deliver nursing care. The use of technology has changed the delivery medium of nursing care. It has necessitated competencies related to its use to deliver nursing care. Practitioners engaged in telenursing plan, assess, evaluate and intervene the outcomes of nursing care. Technologies commonly used in this practice include computers, Internet, telephones, telemonitoring equipment and digital assessment tools. The term telehealth is used to describe the breadth of health services provided through communication technologies. The paper will explore telenursing as a specialty of telehealth. Advantages and disadvantages for the patient and legal and ethical principles for the nurse of this technology will be explored. These will be used as the basis for decision-making and whether it is a good fit for me.

Advantages and disadvantages for the patient
Advantages
Diagnosis and Consultation
Research evidence shows increased success of diagnosis of diseases. Telenursing has productively been used as a tool for diagnosing acute conditions including leukemia. In addition to diagnosis, nurses can provide educational sessions or other patient education efforts. Telenursing has been shown to be a successful undertaking for nurses in patient education as it offers two-way video and audio technology. Nurses also have benefited from consultations through telehealth tools. Just as in patient education, nurses can use the two-way audio and video technology to consult with other providers. For example, home health nurses may use technology to consult with physicians or specialists regarding a particular patient (Hebda & Czar, 2013).

Monitoring and Surveillance
Adherence and compliance problems are among the various issues that are essential to achieving patient safety. After patients leave a facility, they take responsibility for their own health care at home. Patients may not always follow treatment plans as directed by providers or physician due to various factors, including wrong understanding and miscommunication of the treatment plan, complex treatment schedule that requires additional guidance for the patients to comprehend and the lack of access to facilities required for the treatment plan. This can cause negative outcomes and creates safety issues for the patient. Therefore, these technologies provide nurses with efficient tools of caring for patients. The use of these technologies improves adherence or compliance to the prescribed regimen of care. They also allow effective symptom management. Telenursing is one strategy that nurses currently use to monitor and communicate with patients beyond the acute care setting. It also reduces health care utilization rates for acute care services by reducing visits to the Emergency Department (Hebda & Czar, 2013).

Clinical and Health Services outcomes
Telenursing has been associated with an improvement in clinical and health service outcomes. Technologies have been used in the management of chronic conditions such as chronic obstructive pulmonary disease, congestive heart failure and diabetes. Mortality and morbidity are the outcomes measured for these patients. Telenursing shows better outcomes in these areas. More specifically, telenursing technology has been shown to be an important tool in health intervention. For example, nurses can induce communication to help patient reduce HbA1c levels. They may also offer assistance to patients with traumatic brain injury in their transitioning from the hospital to the community. In addition to these technologies, other devices and applications are also making a difference in patient health care and safety. Essentially, telehealth technologies have replaced traditional care as practical alternatives (Hebda & Czar, 2013).

Reduction of cost
With telephone-based telenursing, there is relatively no technical setup required for interaction or cost to the patient. Many individuals own a cell phone in their home that can be utilized during sessions. Often, nurses limit telephone discussions to education or counseling as there are no visual cues for the telenurse. Technologies offer more and broader potential for telenursing practice. With telehealth technologies, patient access to care is improved; adherence to care increases and providers network with each other improves. Nurses can also closely monitor safety of patients at homes or alternative living facilities. The evident improvement in patient’s outcome has an indirect impact on cost of delivery of services (Hebda & Czar, 2013).

Disadvantages
As the use of technology increases in nursing profession, cost, privacy, autonomy, security and confidentiality issues have emerged. Facilities invest heavily in the security of patient information. These measures call for significant allocation of resources interms of human resources and money. Thus, the use of telecommunication increases the costs of purchase and operations of these equipments. These costs are passed on to consumers of health. Patients meet these costs through charges to health services. Health organizations are also faced with continued threat of as the need for confidentiality and security of patient data remain in the forefront of telenursing. On the other hand, Laws and regulations continue to place requirements for the protection of personal information. Data breach incidents have more impact than government fines, publicized lawsuits, and labor or union disputes. Breaches also have an impact on patients. Another disadvantage of telenursing is the technicality associated with the use of specific technologies. Telehealth technology differs and can range from telephone calls postoperatively to live, interactive voice and video patient education to using a popular video game system and downloadable data devices (Schlachta et al., 2010).

Legal and ethical principles for the nurse
With telenursing, confidentiality remains a concern that must always be addressed. Telehealth sessions must remain confidential interaction between a provider and a patient. Information privacy is the relationship between technology, collection and sharing of data, the public expectation of privacy, and the legal and related issues surrounding them. Privacy concerns exist when there is sensitive information or personally identifiable information that might be of interest to other parties. Maintenance of information privacy is a risk management issue for any organization (Greenberg, 2000).

The security risks increase with the extraordinary utilization of internet services due to the advent of cloud computing. Hence, training is a necessary component of an organization’s security practices. Hospitals are forced to instead focus on making information system users intrinsic to the security processes through awareness, training and information rather than focusing purely on implementing technologies. Technologies such as firewalls, intrusion detection system, intrusion prevention system, antivirus content filtering and encryption are commonly implemented to reduce the risk of cyber attacks. While such technologies are widely available to help hospitals mitigate the risk of intentional and unintentional threats, their effectiveness is limited if security threats and risks fail to focus on user intrinsic components of the organization’s ICT system. Computer dependency, false sense of entitlement and ethical flexibility increases the security risk to the disadvantage of the medical facility. This exposes health facilities to risks of security and data breach. In the long run, this may compromise patients’ safety (Greenberg, 2000).

Conclusion and Recommendations
Innovative technologies are employed in nursing practice to improve patient care and thus improve safety. Technologies range from the ubiquitous computing to simple telephone and only promise more in the future. The research on telenursing practice shows significant benefits related to consultations, diagnosis surveillance and monitoring of patients, technology advancement and clinical and health services outcomes. These areas have considerable patient safety concerns. On the other hand, special concerns in relation to patient safety have emerged with this method of health care delivery. As the use of technology increases in nursing profession, cost, privacy, autonomy, security and confidentiality issues have emerged. A job in telenursing is in my future. The pro of this decision is that I will get to work in a field that has shown high potential of growth in the future. The con of this decision is that ability to safeguard data is important as personal information increasingly continues to be collected.