Laminar Air Flow In Controlling Operating Room Infection Nursing Essay

Laminar Air Flow In Controlling Operating Room Infection Nursing Essay Surgical site infections (SSIs) are defined as infections occurring within 30 days after surgical operation or within one year if an implant is left in place and affecting either the incision or deep tissue at the operation site (Owens and Stoessel 2008). SSIs are reported as the major cause of high morbidity and mortality among post -operative patients (Weigelt et.al. 2010). According to UK National Joint Registry Report, during 2003 -2006 period infection was responsible for about 19 % failure of joint surgery resulting in revision procedures (Sandiford and skinner 2009). Micro-organisms in the air particles settle on the wound, dressings and surgical instruments and cause infections (Chow and Yang 2005). Whyte et.al (1982) identified that contamination from patient s skin as the cause of infection in 2% cases and from theatre personnel in 98% cases. They also found that in 30% cases, contaminants reach the wound from theatre personnel via air and in 70% cases it is via hands. Generally air quality in the operating room is maintained ventilation system. Additional improvements can be achieved by laminar air-flow system or UV lights. Laminar air-flow system is expensive and require continues maintenance. Its installation increases building cost and the operational cost (Cacciariet.al., 2004: Hansen, 2005). Studies conducted to evaluate the effectiveness of laminar flow produced mixed results and there is no consensus on its role in infection control (Sandiford 2007). In this setting, this paper reviews the recent studies to examine the effectiveness of laminar air-flow in reducing SSIs. Studies for this review were found by searching on databases such as CINAHL, PubMed, Science Direct, Ovidsp, Science Citation Index (ISI) and Google scholar. Keywords used for this search are laminar air flow , surgical site infection , operating room air quality , airborne infections + operating theatre , LMA + infection control . As laminar air-flow is used mainly in orthopaedic theatres, majority of the studies are on joint surgery. OPERATING THEATRE AIR QUALITY AND INFECTION CONTROL Indoor air in an operating theatre contains dust which consists of substances released from disinfectant and sterilizers, respiratory droplets, insect parts smoke released from cautry. Dust particles act as a carrier for transporting microorganisms laden particles and can settle on surgical wound and there by cause infection (Neil 2005). Air particles are found to be responsible for about 80% 90% of microbial contamination (CDC 2005). Modern operating theatres are generally equipped with conventional ventilation system in which filters can remove airborne particles of size >5mm about 80-95% (Dharan 2002). The efficacy of operating room ventilation is measured by the colony forming units (CFU) of organisms present per cubic meter. The conventional ventilation (Plenum) with 20 air exchanges is considered efficient if it achieves the colony count of 35cfu/m3 or less (Bannister 2002). Ventilation system with laminar air-flow directs the air-flow in one direction and sweeps the air particle over the wound site to the exits (CDC 2003). Laminar air-flow with HEPA (High Efficiency Particulate Arrestment) filters system has the capacity to remove air particles of size 0.3 m up to 99.9 % and can produce 300 air exchanges per hour in ultraclean orthopaedic theatres. (Sandiford and skinner 2009). Laminar air-flow units are generally two types; ceiling-mounted (vertical flow) or wall-mounted (horizontal flow). There are inconveniences associated with both types. Generally the major problem associated with laminar air-flow is flow disruption. With vertical laminar flow, it is the heat generated by surgical lamps creates air turbulence while with horizontal laminar flow it is the surgical team that disrupt the air-flow (Dharan 2002). LAMINAR AIR FLOW IN INFECTION CONTROLL Laminar air-flow system is mainly used in implant surgeries where even a small number of microorganisms can cause infection. In joint replacement surgeries, one of the main causes of early (within 3 months) and delayed (within 18 months to 2 years) deep prosthetic infections was found colonisation during surgery (Knobben 2006). Laminar air flow is supposed to minimize contamination by mobilizing uniform and large volume of clean air to the surgical area and Contaminants are flushed out instantly (Chow and Yang, 2004). Some studies found that this method is effective in reducing infection but some others produced contradicting results (give some reference) A recent study conducted by Kakwani et.al. (2007) found that laminar air-flow system is effective in reducing the reoperation rate in Austin-Moore hemiarthroplasty. Their study compared the reoperation rate between theatres with laminar air-flow and theatres without laminar air-flow system. A cohort of 435 patients who had Austin-Moore hemiarthroplasties at Good Hope Hospital in Birmingham between August 2000 and July 2004 were selected for this study. Of those 435 patients, 212 had operation in laminar air-flow theatres and 223 had operation in non-laminar air-flow theatres. Data were collected by reviewing case notes and radiographs. For all cases antibiotics were administrated and water impervious surgical gowns and drapes were used. In the non-laminar air-flow group it was found that the re-operation rate for all indication in the first year after hemiarthroplasties was 5.8 % (13/223), while in the laminar air-flow group it was 1.4% (3/212). Analysis found that there were no stat istically significant relation between re-operation rate and water impervious gown and drapes (p=0.15), while use of laminar air-flow found a statistically significant drop (p=0.0285) in re-operation rate within the first year after hemiarthroplasties. They found that re-operation rate in no-laminar air-flow theatres were four times greater than that in laminar airflow theatres. Even though the aim of the study was clearly described there was no review of existing studies to identify the gap in the research. Study methods and details of statistical analysis were given elaborately. The sample size seems sufficient. Results were summarized and presented using graphs and charts. Discussion of results was short and seems not adequate to address the objectives of the study. There was no attempt to explain the casual relationship. For example researches were making statements such as the introduction of water-impervious drapes and gowns did not seem to make a statistically significant improvement in the result . (p.823). Researchers failed to acknowledge any limitations of the study. Data for this study was collected by reviewing patients records. Patients records are considers as confidential and researchers didn t mention whether they received consent from the patients or ethical approval form institution to conduct the study. This can be considered as an ethica l flaw of this study. There are studies which found that laminar air-flow system is not effective in reducing infection rate. In their study Brandt C et.al (2008) found that infection rate was substantially high in theatres with laminar air-flow system. This was a retrospective cohort-study based on routine surveillance data from German national nosocomial infections surveillance system (KISS). Hospitals which had performed at least 100 operations between the years 2000 and 2004 were selected for this study. Type of ventilation technology installed in operation rooms of selected hospitals were collected separately through questionnaire from infection control teams in the participating hospitals. Surgical departments were grouped into categories according to the type of ventilation system installed. Departments using artificial operating room (OR) ventilation with either turbulent or laminar airflow was included in this study. Total 63 surgical departments from 55 hospitals were included in this study. Analysis was performed to the data set created by merging the questionnaire data on OR ventilation and surveillance data from the KISS data base. The data set analysed contained 99230 operations with 1901 SSIs. Age and gender of the patient was found a significant risk factor of SSI in most procedures. Univariate analysis conducted found that rate of SSIs was high in departments with laminar air flow ventilation. Multivariate analysis also confirmed this finding. Authors argue that it may be due to the improper positioning theatre personnel in horizontal laminar flow room. Researches provided a well-researched literature review which clearly identified gap in current research. Objectives and design of the study was properly explained. Study was based on a large sample size. Results were discussed in detail and casual relations were well explained. Enough tables were used to present results. Limitations were properly discussed. Knobben et.al (2006) conducted an experimental study to evaluate how systemic changes together with behavioural changes can decreases intra-operative contamination. This study was conducted in the university Medical Centre Groningen, The Netherlands. A random sample of 207 surgical procedures which involved total knee or hip prosthesis from July 2001 to January 2004 was selected for this study. Two sequential series of behavioural and systemic changes were introduced to ascertain their role in reducing intra-operative contamination. The control group consisted 70 cases. Behavioural changes (correct use of plenum) were introduced to the first intervention group of 67 operations. Intense behavioural and systemic changes were introduced to second intervention group of 70 operations. The systemic changes introduced was the installation of new laminar flow with improved airflow from 2700m3/h to 8100m3/h. Two samples each were taken from used instruments, unused instruments and removed bon es. Control swabs were also collected to make sure that contamination was not occurred during transport and culturing. Early and late intra-operative contamination was also checked. All patients were monitored for any wound discharge while in hospital and followed-up for 18 months to check whether intra-operative contamination affects post-operative infection. Among the control group contamination was found 32.9% while in intervention group 1 it was 34.3% and in intervention group 2 it was 8.6%. Except in Group 1 (p=0.022) late phase contamination was not significantly higher than early phase contamination. During the control period wound discharge was found in 22.9% patients and 11.4% of them had wound infection later. Deep periprosthetic infection had been found in 7.1% of them in the follow-up period. Deep periprosthetic infection was found in 4.5% cases of first intervention group and in 1.4% of cases in second intervention group in the follow-up period. But none of these decreases were found statistically significant. Contamination, prolonged wound discharge and superficial surgical site infection were found decreased after both first and second intervention. But a statistically significant reduction was found only in second intervention (contamination p=0.001, wound discharge p=0.002 and superficial SSI p=0.004). This study concluded that behaviour modifications together with improved air flow system can reduce intra-operative contamination substantially. Purpose of the study was clearly defined and a good review of the current literature has given. Gap in current research was clearly presented and justification for the study had given. Sample size seems sufficient. It is reported that .bacterial cultures were taken during 207 random operations (p. 176), but no details of the sampling method used were provided. Details of interventions were given elaborately and results were discussed in detail. But only one table and two charts used to present it. The readers would have been more benefited if more tables were used to present the results. Discussions of the results were concise and findings were specific and satisfying the objective. No information on whether they received informed consent from the patients and approval form the ethical committee of the institution was missing. This arise a serious question about the ethics of this study. It is found that laminar airflow is more effective when use in conjunction with occlusive clothing (Charnley, 1969 cited in Sandiford and Skinner 2009). While in their recent study Miner et.al (2007) compared the effectiveness of laminar airflow system and body exhaust suits found that body exhaust suits are more effective than laminar flow system in reducing infection. For their study Miner et.al (2007) selected 411 hospitals which have submitted the claim for total knee surgery (TKR) for the year 2000 from four US States were surveyed to collect the details of use of laminar air flow system and body exhaust suits. Those hospitals which were fulfilled three criteria were included in this study. The inclusion criteria were 1) returned the survey instrument, 2) using laminar air flow system or body exhaust suits for infection control and 3) was evidence of at least one Medicare claim for TKR for the study period. Total 8288 TKRs performed in 256 hospitals between 1st January and 30th August 2000 were selected. Data on patient outcomes after total knee replacement (TKR) were collected from Medicare claims. The patients who underwent bilateral TKR were not included in this study and for those who underwent a second TKR during a separate hospitalisation during the study period, only the first procedure was included. International Classification of Disea ses, Ninth Revision (ICDS-9) codes was used to identify post-operative deep infection that needed additional operation. Hospitals were grouped as users or non-users for both laminar airflow and body exhaust suits. Users were defined as those who use any of these methods in more than 75% procedures and non-users were those use any methods less than 75%. The over-all 90-day incidence of deep infection, subsequent operation was found required only in 28 cases (that is 0.34%). Analysis found that the risk ratio for laminar airflow system was higher (1.57, 95% confidence interval 0.75-3.31) than body exhaust suits (0.75, 95% confidence interval 0.34-1.62). Study found that there were no significant differences in infection between hospitals that use specific either protective measure. Other than mentioning few studies researchers failed to provide any background of the research problem. Methods used for this study were explained concisely. Even though the sample size was large, limited number of events (28) were there to be observed. Analysis was based on this small number of events; this may have affected the result. Not many variables were included in this study, and researchers didn t mention how they controlled some possible confounders. Researchers were successful in identifying the advantages and limitations of the study. Results were properly presented in tables. Instead of expensive laminar air-flow system, installation of well-designed ventilation system is found beneficial. Scaltriti et.al (2007) conducted a study in Italy to examine effectiveness of well-designed ventilation system on air quality in operation theatre. They selected operation theatres of a newly built 300 beds community hospital which have ventilation system designed to achieve 15 complete outdoor air changes per hour and are equipped with 0.3 m, 99.97% HEPA filters. All these satisfy the condition for a clean room as per ISO 7 standard. Passive samples of microbiological air counts were collected using Tripticase Soy Agar 90 mm plates left open thorough out the duration of the procedure. Active samples were also collected using a single state slit-type impactor. Total 82 microbiological samples were collected of which 69 were passive plates and 13 were active. Air dust was counted with a light-scattering particle analyser. Details of the surgery, number of people in the r oom, door opening rate and estimated total use of the electrocautery unit were also collected. It was found that there were positive correlations between particle contamination, surgical technique (higher risk from general conventional surgery), electrocauterization and operation length. Door opening rate was found negatively associated. Researchers suggest that this may because when theatre door open a turbulent air flow blows out of the operating room which may result decrease in the dust particles. No association was found between particle contamination and number of people present at the time of incision. Researchers suggest that human movement rather than human presence is the factor that determines airborne microbial contamination. It was found that average particle concentration in the theatres did not exceed the European ISO 14 644 standard limits for ISO 7 clean room, and so concluded that well-designed ventilation system is effective in limiting particulate contamination. Uncultivable or unidentifiable organisms can also be a reason for surgical site infections. It may be difficult to identify such organisms through standard culture techniques (Tunney 1998). Clarke et.al (2004) conducted a quantitative study to examine the effectiveness of ultra-clean (vertical laminar flow) theatres in preventing infections by unidentifiable organisms. They used the molecular technique, Polymerase Chain Reaction (PCR), to detect bacteria presence. Their study compared the wound contamination during primary total hip replacement (THR) performed in standard and ultra clean operation theatres. 20 patients underwent primary THR from 1999 to 2001 were recruited for this study. Patients with previous incidents of joint surgery or infection were excluded. The standard operation theatres had 20 air changes per hour and CFU count was 50 CFU/m3, while ultra-modern theatres had 530 air changes per hour and CFU count was 3 CFU/m3. For all surgeries same infection control precautions were used. Two specimens each of pericapsular tissues were collected from posterior joint capsule both at the beginning and at the end of the surgery (total 80 samples). Patients were given antibiotic prophylaxis after taking the first specimen. All these samples were underwent Gram stain and culture to detect bacterial colonies and Polymerase Chain Reaction (PCR) to detect bacterial DNA. Among the 20 specimens taken form the standard operation theatres at the beginning of the surgery only 3 were found positive with PCR, while from the ultra-clean theatres only 2 were found positive. None from both theatres found positive with culture. Samples from the standard theatres taken at the end of the surgery, 2 found positive by culture and 9 found positive by PCR. The contamination rate in the standard theatre at the end of the surgery found significantly greater than the beginning (p=0.04). Samples taken from the ultra-clean theatres, none was positive by culture while only 6 were positive by PCR. Statistical analysis found that contamination rate at the end of the surgery is not statistically different than the start (p=0.1). It was found that there were no statistically significant difference in overall contamination rate (p=0.3) between standard and ultra clean theatres. (I will add critique of this study here) NURSES ROLE IN INFECTION CONTROL Understanding the source of contamination in operating theatre and knowing the relationship between bacterial virulence, patient immune status and wound environment will help in improving the infection rates (Byrne et al 2007). Nurses are responsible to take a proactive role in ensuring safety of their patients. To improve patient outcome, it is necessary for the nurses to take lead role in environmental control and identifying hazards through environmental surveillance (Neil 2005). Non-adherence to the principle of asepsis by surgical team is identified as a significant risk factor of infections. Hectic movement of surgical team members in the operating room and presence of one or more visitors were also found as major causes of SSI (Beldi G 2009). Nurses and managers should emphasise on controlling factors like the traffic in theatre, limiting the number of staff and reinforcement of strict aseptic technique (Allen 2010). Creedon (2005) argues that infections can reduce up to one third if staffs follow best practice principles. For better outcome staffs needs additional education and positive reinforcement. Nurses have a vital role in the development, reviewing and approving of patient care policies regarding infection control. Nurses are not only responsible for practicing the aseptic techniques but also responsible for monitoring other staff for their adherence to policies. They are responsible for developing training programmes for members of staff. Educating the environmental services personnel like technicians, cleaners will not only improve their knowledge in patient care but also provide a sense of commitment in patient outcomes (Neil 2005). Perioperative nurses can contribute in research regarding theatre ventilation system through organised data collection and documenting evidences. Nurses can contribute in giving optimum and safe delivery of care in areas where environmental issues can put the patient at risk. Knowledge is changing fast, so it is important that staff must keep themselves up to date. Continues quality improvement is needed and it should be based on evidence based research and on-going assessment of information (Hughes 2009). CONCLUSION Reviews of current research shows that still there is a lack consensus on the effectiveness of laminar airflow in infection control. Studies include in this review has used either clinical outcomes (infection or reoperation rate) or intermediate outcomes (particle count or bacterial count) to evaluate the effectiveness of laminar flow. Kakwani et.al (2007) found that re-operation rate was lower in laminar airflow theatres but Brandt et.al (2008) found SSI rate was high in hospitals with laminar flow. Clarke et.al (2004) found that contamination was not significantly different in ultra clean theatres compared to standard theatres equipped enhanced ventilation system. Supporting this finding Scaltriti et.al (2007) found well designed ventilation system is effective in reducing contamination. Study by Knobben et.al (2006) found that combination of systemic and behavioural changes are required to prevent intra-operative contamination. Miner et.al (2007) found that there were no significant differences in infection between hospitals that use laminar airflow and body exhaust suits. From these studies it can be concluded that use of laminar airflow alone can guarantee infection prevention. Behavioural and other systemic changes are necessary to enhance the benefits of laminar airflow. Evidence shows that conventional theatres equipped with enhanced ventilation system can prevent infection effectively, this can be consider as an alternative for expensive as laminar flow system.

Privacy in the Workplace Essay

There are specific laws that protect consumers as well as employees in the workplace. Many of these laws relate to others. Laws, such as, FERPA, SOX, CIPA, and COPPA also grant rights to individuals under the First Amendment. Family Educational Rights and Privacy Act (FERPA) protects a child’s student records from being viewed without parental consent. It gives parents access to their child’s education records, an opportunity to seek to have the records amended, and some control over the disclosure of information from the records. When the child becomes 18 years old, the parents are no longer obligated to have rights to access the child’s personal records. Children’s Internet Protection Act (CIPA) is also engineered to the protection of children. Children are to be protected physically and mentally while in the care of school professionals. Schools must have policies in place protecting children from accessing harmful or obscene content over the internet. This law requires that K-12 schools and libraries in the United States use Internet filters and implement other measures to protect children from harmful online content as a condition for federal funding. The Child Online Protection Act (COPPA) applies to the online collection of personal information by persons or entities under U.S. jurisdiction from children under 13 years of age. It details what a website operator must include in a privacy policy, when and how to seek verifiable consent from a parent or guardian, and what responsibilities an operator has to protect children’s privacy and safety online including restrictions on the marketing to those under 13. While children under 13 can legally give out personal information with their parents’ permission, many websites disallow underage  children from using their services altogether due to the amount of cash and work involved in the law compliance. Sarbanes–Oxley (SOX) set new or enhanced standards for all U.S. public company boards, management and public accounting firms. The sections of the bill cover responsibilities of a public corporation’s board of directors, adds criminal penalties for certain misconduct, and required the Securities and Exchange Commission to create regulations to define how public corporations are to comply with the law.

Thrift Savings Plan

Thrift Savings Plan HRA-360 Total Compensation Dr. James Waters Jacqueline Kelly 2 March 2010 Every successful organization depends on the abilities of a good workforce. The United States Government is no different. One of the major concerns of most employees is receiving fair compensation for the work performed, even after retirement. In 1920 the U S Federal government provided retirement, disability and survivor benefits for most civilian employees. The plan continues to provide benefits to those still covered under the plan. Employees covered under CSRC were not covered by Social Security. However, realizing a need for change, the United States Congress designed a new program, the Thrift Savings Plan, which was enacted 6 June 1986 and became effective 1 January 1987 in the Federal Employees Retirement Act of 1986. The Thrift Savings Plan is meant to operate like a 401(k) retirement savings plan. The plan permits employees to defer paying taxes on the money saved until they retire, at which time they may be in a lower tax bracket because they are no longer earning a full time income. The Thrift Savings Plan is one of the three parts of the Federal Employees Retirement System, and is the largest defined contribution plan in the world with assets worth over $210 billion dollars. The Thrift Savings Plan has the over 3. 7 million participants who contribute to the plan on a voluntary basis. Some these civilian participants included: Individuals on approved leave without pay to serve as full-time officers or employees of certain unions or other employee organizations Individuals assigned from a Federal agency to a state or local government under an Intergovernmental Personnel Act assignment who choose to retain FERS or CSRS coverage Individuals appointed or otherwise assigned to one of the Cooperative Extension Services, as defined by the National Agricultural Research, Extension, and Teaching Policy Act of 1977 Federal justice and judges, certain Federal bankruptcy judges and magistrate judges, Claims Court judges, and Court of Veteran Appeals judges Nonappropriated Fund employees of the Defense Department or the U. S. Coast Guard who have chosen to be covered by FERS or CSRS. According to an rticle in the Business Source Complete, participants in the TSP are disproportionately male, higher earners, older, full-time workers, and either white or nonblack minorities compa red with the population at large. I expect this number to continue to grow as people’s concerns increase about Social Security’s existence further down the road. Employees in the Federal Retirement System are limited to contributing 10 percent of their earned income to the program and the federal government will match up to 10 percent. Employees who fall under the Civil Service Retirement System (CSRS) who are not covered by Social Security may invest up to 5 percent of their earnings to the TSP. The federal government contributes 1 percent to TSP accounts for all employees covered under the Federal Employees Retirement System. Many government employees obviously consider this program an important compensation and they continue to increase their contributions as their earnings increase. Data collected by the Department of Labor, the Employee Benefit Research Institute, and the Federal Retirement Thrift Investment Board for 1992, 1993, and 1997 noted that the TSP had a participation rate of 79 percent, which is more than the 68 percent eligible workers utilizing 401(k) plans, and 8 percent participating in IRAs. A contributing factor to the differences in the number of employees participating in the different programs may be the fact that government employees have a wealth of knowledge available to them on the TSP. They are able to monitor their accounts daily on the internet. In addition, changes may be made on how much is contributed and they may borrow from the account when necessary with minimal penalties. Although, they are advised that the account are established for long-term investing in their future are retirement. Federal employees under FERS have noted a pivotal reason they participate in the program is because of the matching contributions and those employees under CSRS tout the tax benefit as their main reason for participating in the program. Many people consider landing a government a great feat because of the benefits of getting all federal holidays off with pay, vacation and sick leave, and most time tuition reimbursement. But the TSP may now be very a sought after component of a compensation package. An added benefit to the TSP is workers are fully vested in the 1 percent agency automatic contributions after three years( two years for congressional employees and executive-branch political appointees). In addition, workers who leave the federal government for jobs in other sectors of the economy can leave their money in the TSP and it will continue to accrue interest, dividends, and capital gains according to the performance of the funds in which they have chosen to invest. If they opt not to leave their money in the TSP, they may roll it over into another investment vehicle such as an IRA or a 401(k) plan. Furthermore, there are no huge fees for management of the account. A draw back to the TSP is new hires have a waiting period of 6 to 1 year before they can reap the benefit of employer matching contributions. However, they may rollover distributions into the TSP form other tax-qualified retirement savings plans from private-sector firms. Provided certain criteria are met. The TSP is now available to military personnel. On October 30, 2000, the Floyd D. Spence National Defense Authorization Act for Fiscal Year 2001 (Public Law 106-398) was signed. One provision of the law extended participation in the TSP, which was originally only for Federal civilian employees, to members of the uniformed services. The uniformed services include: †¢Department of the Army †¢Department of the Navy †¢Department of the Air Force †¢United States Marine Corps †¢United States Coast Guard †¢Public Health Service †¢National Oceanic and Atmospheric Administration All contributions made by civilians and military personnel are made by way of automatic payroll deductions. They also had a limit of which they could contribute, mandated by the IRS of $15,500. Fortunately, employees over the age of 50 have a provision that allows for a little catch up, in that they may contribute an additional $5,000 annually. Employees may also make early withdrawals without penalty from the IRS if they need the money to pay for medical expenses of the plan participant, a spouse, or dependent, but only to the extent that they exceed 7. 5 percent of adjusted gross income. Ironically, funds may be withdrawn through an IRS levy to collect back taxes owed by the plan participant. Another allowable withdrawal may be for an alternate payee under a qualified domestic relations order (QDRO). Also, early distribution is permissible if it is part of a series of substantially equal periodic payments (SEPPs) over the life of the participant or the joint lives of the participant and the beneficiary. Both CSRS and the FERS retirement pension plans are determined by multiplying three factors: the salary base, the accrual rate, and the number of years of service. Salary base is the final average pay, usually their highest, before retirement. Nevertheless, while the TSP is an outstanding compensation for federal employees it does have some disadvantages. The Thrift Savings Plan is a defined contribution plan similar to a savings account maintained by the employer on behalf of each participating employee. The combined amounts contributed by the employee and employer are invested in stocks and bonds but the employer has no financial obligation other than making contributions to the employees retirement account. All the investment risks fall on the employee. If they do not invest enough for a comfortable retirement, or if the investments lose value or increase too slowly, the employee bears the burden of not having adequate income for retirement. If an employee withdraws from the fund before age 59 they will pay an additional 10 percent tax penalty. This additional tax does not apply to the beneficiary after the death of the participant of if the participant becomes disabled. I feel the government TSP is an excellent compensation afforded to civilian employees because they receive a specific dollar amount matched by Uncle Sam. They are able to make payroll deductions directly into the account and are able to manage their account directly through the internet. Employees covered by FERS have an amount equal to 1 percent of pay contributed to the Thrift Savings Plan by their employing agencies, even if the employee makes no voluntary contributions to the TSP. This amount is not deducted from employee pay. It is paid by the employing agency from sums appropriated to it by Congress for salaries and related expenses. Assuming a nominal annual investment return of 6. 0 percent, an employee who retires after 30 years of federal employment will be able to replace only about 3 percent of final salary from his or her TSP account if he or she never makes a voluntary contribution to the plan. Although it is minimal, employees can still benefit from the plan without contributing a penny. Without using a financial advisor, they have the ability to make intranet transfers on their accounts. Thrift Plan participants can receive account-balance information and conduct transactions using an automated phone system or on the Thrift Plan’s Website at www. tsp. gov. The plans seem relatively simple to understand. Employees no longer have to wait for an open enrollment period to make changes to their account. Government and military personnel have two choices on the bond side to invest in. If they want to invest in a low risk bond, the choice is the â€Å"G Fund† which invests in government securities, or the â€Å"F Fund,† which is tracks the Lehman Brothers Aggregate Bond Index. There’s a target maturity plan which they call â€Å"Life Cycle,† or â€Å"L Funds†. Basically, they way the plan works is participants select the fund whose target date corresponds most with the year they hope to retire. It is a diversified portfolio, investing in the C, F, G, S, and I funds that become more conservative as the participant nears their retirement age. The â€Å"C† fund invests in stocks of all of the corporations that represented in the Standard and Poor’s 500 index. The â€Å"F† fund, or â€Å"Fixed Income Index Investment Fund† invests in securities represented in the Shearson Lehman Brothers Aggregate (SLBA) bond index. They are comprised of government bonds, corporate bonds, and mortgage-backed securities. The â€Å"G† fund consist of U. S. government securities and pays interest equal to the average rate of return on long-term U. S. government bonds. This is a very low risk fund and considered the safest of the TSP funds because the principal is guaranteed not to drop in value. The â€Å"S† fund (Small Capitalization Stock Index Fund) invest in the common stocks that are represented in the Wilshire 4500 index. The â€Å"I† fund (International Stock Index Fund) invests in the stocks of foreign corporations represented in the Morgan Stanley Capital Investment EAFE(Europe, Australia-Asia, Far East) index. The â€Å"Life Cycle† Fund uses a combination of these five funds to optimize returns for employees depending on the time frame they have chosen for their expected retirement. The Thrift Savings Plan (TSP) plays a fundamental role in helping federal workers achieve adequate financial resources for retirement. Employees covered by FERS who do not make voluntary contributions to the TSP, and thus receive only the 1 percent agency automatic contribution, will be able to replace only 2 percent to 4 percent of final annual salary from the TSP at retirement. Most workers in the lower and middle ranges of the federal salary scale will be able to achieve the 60 percent salary replacement. The TSP makes for an admirable compensation feature for many of the active duty military retirees who seek employment with the federal government after retirement. This would be icing on the cake since the military uses the benefits plan based on salary earned in the years immediately preceding retirement which they start receiving the month after they are completely retired from active duty. I could see how the â€Å"double dippers,† as they are called, may be able to maximize on the TSP using their retirement income. It would allow for employees need for security to be satisfied in knowing that after retirement they may have an adequate income after they leave government service if their funds are invested wisely. They would still be able to meet their physiological, safety and security needs, which is especially important in retirement years. That in turn should help to keep their spirit and self esteem up because they are still able to provide for themselves and others that depend on them which should bring a sense of belonging and love. Ultimately, being able to participate in the Thrift Savings Plan, in the public or private sector, sends a message tol employees that their employer or the U S government thought enough of the people who work for them to implement a compensation plan to reward them for their years of service to the organization. I think if more employees had a compensation package that included a benefit similar to the Thrift Savings Plans less people would be concerned about the solvency of Social Security. Federal employees at all income levels can significantly boost their retirement income by contributing to the TSP, and such contributions are essential in order for those in the upper third of the federal pay scale to achieve a level of income that will allow them to maintain their pre-retirement standard of living. References Purcell, P. (2007). Federal employees' retirement system: The role of the thrift savings plan. Journal of deferred compensation, 13(1), 74-99. Retrieved from Business Source Premier database. Springstead, G. , & Wilson, T. (2000) Participation in voluntary individual savings accounts: An analysis of IRAs, 401 (K)s, and the TSP. Social Security Bulletin, 63(1), 34. Retrieved from Business Premier database. (2007). Thrift Savings Plan participant survey results 2006. Pension Benefits, 16(5), 11. Retrieved from Business Source Premier database (2008). Federal Thrift Plan mirrors 401(k) Plans. 401K Advisor, 15(11), 8-9. Retrieved from Business Source Premier database. Barkume, A. (2004). Using incentive pay and providing pay supplements in US job markets. Industrial Relations, 43 (3), 618-633. Dolmat-Connell, J. , Dolmat-Connell, S. , & Miller, G. (2009). Potential implications of the economic downturn for executive compensation. Compensation & Benefits Review,41, 33-38. Gerhart, B. , & Rynes, S. (2003). Compensation: Theory, evidence, and strategic implications. Los Angeles, CA: Sage Publications. Hansen, F. (2010). Currents in compensation and benefits. Compensation & Benefits Review, 42: 3-15. Henderson, R. (2006). Compensation management in a knowledge-based world (10th edition). Upper Saddle Creek, NJ: Prentice Hall/Pearson. Milkovich, G. , & M. Newman, J. (2008). Compensation (9th edition). New York, NY: McGraw Hill Publishers.

The Beauty Standard On The Average Person - 1237 Words

Monkey see, monkey do is an unfortunate saying that captures the effect of the beauty standard on the average person. Our culture and industry bombard us with images of women with features far from the norm. This has caused many women to look and compare themselves with a very unnatural image. Many have tried to replicate the model body they see, without considering the harm that it could cause. The beauty standard today is not what it should be because the industry is manipulative, it makes women insecure about themselves, and is responsible for potential health effects. The ideal body image has ironically changed for the worst. Beauty trends no longer rely on natural methods such as a good diet, exercise, and makeup, but now include plastic surgery, implants, stomach stapling, chemical peels and more (Graydon). Even trends that were deemed harmful in the past are being brought up again, like corset wearing, which has been popularized by celebrity Kim Kardashian. Many people are mad e aware or even choosing to follow these trends due to the culture we live in. It is a culture where no one is satisfied with what they have because we are constantly comparing ourselves to something that is seemingly better. The â€Å"Contrast Effect† is a psychological explanation for this self-judgement. Essentially, people feel less attractive when they’re around more attractive people and vice versa. This heightened self-consciousness focuses too much on bodily imperfections (Flora). EverythingShow MoreRelatedBeauty Industry Has A Big Impact On Females And Males1416 Words   |  6 PagesBeauty can be conveyed using a multitude of factors. From the color of a person s skin, to their eyes, to even their heart. There are beauty standards, but there are diversities between what s the â€Å"official† standard and what individuals think is beautiful. Everyone see things in a different light and America s beauty standards are no different. 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