Writing and drawing paper
Wednesday, August 26, 2020
Managing Organizational Change - Project proposal Essay
Overseeing Organizational Change - Project proposition - Essay Example While experiencing literary works, I discovered dazzling that ââ¬Ëresistance is an asset, a chance and a powerââ¬â¢ (Palmer, Dunford and Akin, 2009 and Ford and Ford, 2009) as obstruction can assist administrators with increasing more thoughts and input about the proposed changes. The course venture paper will think about this as an individual model for explicit change the executives and portray its hypothetical points of view and down to earth confirmations dependent on important written works. Exploratory examination will be utilized in the paper to portray the change the board idea of ââ¬Ëresistance to changeââ¬â¢ and to investigate vital activities to oversee opposition, in light of checking on different significant literary works in the field, taken from books and diaries got to from sources like EBSCO, Emerald and so forth. Aside from the course reading material, diaries will be utilized to audit the writing that investigates hierarchical protection from change. Out of diary sources, the insightful articles, Decoding Resistance to Change: Strong pioneers can hear and gain from their faultfinders by Ford and Ford (2009) and Navigating Organizational Change: Change Leaders, Employee Resistance and Work-based Identities by Dijk, R. V and Dick, R. V (2009) will be of more prominent use in the examination paper as these sources have nitty gritty much about overseeing opposition and moving toward it as force and
Saturday, August 22, 2020
Case of Dell in Australia Essay Example | Topics and Well Written Essays - 1000 words
Instance of Dell in Australia - Essay Example B2B and B2C become the primary models utilized by organizations to arrive at their intended interest groups gesture satisfy clients needs (Bearden et al 2004). It appears to be likely that immediate selling from the producer will develop exponentially. In reality, it is this very transferability of data which for all intents and purposes ensures the death of conventional industry limits. Organizations are progressively finding that, in the event that they join their data resources with those of different organizations, the consolidated data asset is significantly increasingly helpful to all sides: two and two, in this example, can make much more than four. Set up a government managed savings or duty database with another database of individuals who owe obligations and you have a methods for following individual indebted individuals over extensive stretches of time and gathering the obligation from them when they at long last have the cash to reimburse it (a procedure is known as obli gation reconnaissance and right now being offered by certain organizations) (Dedrick and Kraemer 2001). The corporate destinations of Dell are to make self improvement increasingly valuable and simpler to utilize, improve client care and direct client connections. The unmistakable and viable methodology permits an organization to reclassify itself â⬠at all levels, from procedure to the activity of individual procedures (Drejer, 2002). Dell, an organization that is nearly unconstrained by physical geology (a dealer of administrations over the Internet, for instance) can reconfigure its conveyance to exploit the changes in residential expense systems at essentially no cost: it doesn't have any physical resources of any result that should be migrated. For dell, its worth chain can be viewed as a progression of interrelated capacities inside any association that connect its sources of info (crude materials to an industrial facility, inbound coordinations to a retail outlet) to its yields (outbound coordinations, the offer of merchandise to clients), the virtual worth chain alludes to t he worth that can be created by abusing the data produced by any phase of thisâ process.
Friday, August 21, 2020
PSA The 2016 Siemens Competition is now open
PSA The 2016 Siemens Competition is now open As Ive blogged before, many students who are interested in MIT are also interested in high school research competitions, including (but not limited to) those listed on our enrichment opportunities page. One of these is the Siemens Research Competition. MIT is a University Partner for Siemens, which means that we host a (virtual) regional event and provide volunteer judges to review student projects. All students in grades 9-12 during the 2016-2017 school year are eligible to win up to $100,000 in college scholarships through their participation in the competition. Siemens encourages all students, working as individuals or in teams, to submit research they are currently working on or to begin research now with the goal of applying. You can review the student entrant toolkit, as well as competition flyers, in both English and Spanish at the Siemens Research Competition Resources page. The deadline for submission is September 20th, 2016. Just wanted to share a PSA! Sorry I havent blogged much over the last few weeks. Ive been mostly traveling since ISEF and it took me awhile to get back and then to get my life back together. Will have more stuff for you all soon!
PSA The 2016 Siemens Competition is now open
PSA The 2016 Siemens Competition is now open As Ive blogged before, many students who are interested in MIT are also interested in high school research competitions, including (but not limited to) those listed on our enrichment opportunities page. One of these is the Siemens Research Competition. MIT is a University Partner for Siemens, which means that we host a (virtual) regional event and provide volunteer judges to review student projects. All students in grades 9-12 during the 2016-2017 school year are eligible to win up to $100,000 in college scholarships through their participation in the competition. Siemens encourages all students, working as individuals or in teams, to submit research they are currently working on or to begin research now with the goal of applying. You can review the student entrant toolkit, as well as competition flyers, in both English and Spanish at the Siemens Research Competition Resources page. The deadline for submission is September 20th, 2016. Just wanted to share a PSA! Sorry I havent blogged much over the last few weeks. Ive been mostly traveling since ISEF and it took me awhile to get back and then to get my life back together. Will have more stuff for you all soon!
Wednesday, May 13, 2020
Taxonomy Lab to Show Organism Relationships - 995 Words
Name: Date: March 16, 2014 Instructorââ¬â¢s Name: Professor Tyra Hall ââ¬â Pogar Assignment: SCIE207 Phase 5 Lab Report Title: Taxonomy Lab to Show Organism Relationships Instructions: You will need to fill out the data table and answer a set of questions. When your lab report is complete, post it in Submitted Assignment files. Part 1: Using the lab animation, fill in the following data tables to help you answer the questions that follow: Table 1: Samples 1ââ¬â5 Phylum/Division | Sample 1: Chrysophyta | Sample 2: Annelida | Sample 3: Arthropoda | Sample 4: Amphibia | Sample 5: Aves | Common Feature | Unicellular, primary producers| Segmented body | External skeleton and segmented body | Can obtain oxygen fromâ⬠¦show more contentâ⬠¦| Diffusion | Nephridia in each segment; solid waste exits through the anus | Malpighian tubules | Kidneys, intestines, anus | Kidneys, intestines, anus | Growth and Development Does the organism go through metamorphosis, develop in an egg or uterus, or grow from seeds? | Start as small cells; grow bigger until division | Start out as fertilized eggs, hatch into little worms that continue to grow, and then mature sexually into adults | Complete (egg, larvae, pupae, adult) or incomplete (egg, nymph, adult) metamorphosis | Metamorphosis: Egg, tadpole, adult | Develop in egg | RegulationHow does the organism control body processes (hormones, nervous system)? | The nucleus directs protein synthesis. Euglena ha ve eye spots that can detect light | Tiny anterior brain, ganglia, and the nerve cord runs the length of the body | Tiny anterior brain, nerve cord, ganglia, and extremely well-developed sensory organs | Brain, nervous system, good reflexes | Nervous and endocrine systems | Sample organism | Phytoplankton * Chrysophyta | Earthworm * Annelida | Fruit fly * Arthropoda | Frog * Amphibia | Bird * Aves | Table 2: Samples 6ââ¬â10 Phylum/Division | Sample 6: Reptilians |Show MoreRelatedLab : The Different Types Of Living Organisms805 Words à |à 4 PagesChandini Shirupalli Date of Lab performed: 9/14/15 Date it was submitted: 9/21/15 Lab 1# Systematics and Taxonomy Pages 2-10 Purpose of the Lab: The purpose of the lab is to show the different types of living organisms. Also, to show how Woeseââ¬â¢s system of classification, was used to organize information about many types of organisms. So that you can define the organisms. This shows what the purpose is for the Systematics and Taxonomy Lab. Background information: Classification systems startedRead MoreWeek 5 Lab Systematics1297 Words à |à 6 Pagesï » ¿Virtual Systematics Lab: Introduction to Systematics Worksheet Learning Goal: To learn how biologists classify species based on their evolutionary relationships. Prerequisite Knowledge: Before beginning this lab, you should be familiar with these concepts: why biologists today use the three-domain system of classification how evolutionary trees depict biologistsââ¬â¢ understandings about the evolutionary relationships among groups of organisms Introduction: Almost every place on Earth, from the surfaceRead MoreThe Taxonomy of a Frog Essay1080 Words à |à 5 Pagesfunction like many other organisms. The systems that were analyzed through dissection were the epidermis, muscles, digestive, urogential, circulatory, and respiratory system. All systems, including the skeletal, and nervous system, were compared to organisms rudimentary and advanced to the frog. The life cycle and taxonomy of a frog were also researched during this lab. Through frog dissection, an individual may expand their knowledge of multiple body systems in organisms like their own. The systemsRead MoreDna Rn The Biological Diversity1295 Words à |à 6 Pagesin Microbial Diversity Biodiversity is also known as the biological diversity. Biodiversity refers to all kinds of organism that can be found in a particular area.it includes a variety of plants, animals, fungi and other living things. Biodiversity of an ecosystem, is a community of animals, plants, and living things in relationship to their environment, which can be physical or chemical. Microbial diversity can be defined as the different kinds of microorganism which includesRead MoreIdentification Of Unknown Organisms And Two Eukaryotes3349 Words à |à 14 PagesIdentification of Unknown Organisms Benjamin Nibarger Professor Hoffman Monday 11:15 AM Group Members - Jamie Jerome, Natalie Perez, Ruth Pinzon September 27, 2014 ââ¬Æ' Introduction The purpose of this study is to identify four unknown organisms. The unknown organisms have been assigned randomly to six-research groups by Professor Hoffman. Each research group was provided two eukaryotes and two prokaryotes. The unknown organisms will fall into the following classifications: bacteria, algae, fungiRead MoreRio bio4115 Words à |à 17 PagesWATER WILL MOVE INTO THE CELL 12. CHLOROPLAST 13. GREEN 14. IN THE STROMA 15. H20 16. IT EXCITES ELECTRONS IN CHLOROPHYLL 17. Making sugar 18. pigment, then to chlorophyll A 19. WATER SPLITTING 20. ELECTRONS ARE PASSED DOWN DEPENDENT REACTIONS Lab 5 1. a. What is the name of the pigment that captures light? (2 points) b. Why does the pigment appear green? (2 points) --Answer below: A. Chlorophyll B. Due to wavelengths of light that appear green to the human eye. 2. List two variablesRead MoreRat Dissection1914 Words à |à 8 Pagesother. For example, the capital letter T and an isosceles triangle are bilaterally symmetrical. The biology term is to organisms that have two symmetrical halves when divided along only one plane. 11. What is dissection? Dissectionà is the process of disassembling and observing something to determine its internal structure and as an aid to discerning the functions and relationships of its components. 12. Why would a scientist do a dissection? Scientists perform dissections in order to view the anatomyRead MoreGreat Minds: The Essential Guide for Teachers7827 Words à |à 32 PagesGuide Educational philosophies are complex and wide-ranging. In this TES Essential Guide, James Williams, a lecturer in education at the University of Sussex, makes sense of it all. Theory and practice 4 What itââ¬â¢s all about. Bloomââ¬â¢s taxonomy of learning 8 Bloomââ¬â¢s theory links the knowledge we have to how to we think, explains how attitude affects motivation and how our ability to do practical things changes the way we learn. Behaviourist approaches 12 Behaviourist theoriesRead MoreThemes in the Study of Life5755 Words à |à 24 PagesChapter 1 Introduction: Themes in the Study of Life Lecture Outline Overview: Inquiring About Life â⬠¢ Organisms are adapted to the environments they live in. â⬠¢ These adaptations are the result of evolution, the fundamental organizing principle of biology and the core theme of this book. â⬠¢ Posing questions about the living world and seeking science-based answers are the central activities of biology, the scientific study of life. â⬠¢ Biologists ask a wide variety of ambitious questions. Read MoreHbr When Your Core Business Is Dying74686 Words à |à 299 Pages66 90 The Leadership Team: Complementary Strengths or Conï ¬âicting Agendas? Stephen A. Miles and Michael D. Watkins When members of a leadership team play complementary roles, the whole is often greater than the sum of its parts ââ¬â but such relationships may also result in confusion, especially when members move on. Organizations can learn to enjoy the advantages and minimize the risks of complementarity without sowing the seeds of disaster during succession. 100 100 Avoiding Integrity Land
Wednesday, May 6, 2020
The Downside Risk of Illustration Essay Thesis That No One Is Talking About
The Downside Risk of Illustration Essay Thesis That No One Is Talking About The Illustration Essay Thesis Cover Up Etc then there's summary conclusion at which you will give a brief review of the whole essay. It's probable that, whatever your educational objectives, you will gradually compose a book report. A book review provides the opinions of the author and includes his personal views. It is not the same as a book report, and the distinction will be made between the two. The One Thing to Do for Illustration Essay Thesis Writing a thesis is easily the most challenging undertaking for the majority of students. Methodology is the part that also can bring about trouble even in the event that you think that you are aware of how to do it. Key Pieces of Illustration Essay Thesis Then you'll need to revise your thesis statement while you're writing the paper. No wonder it's as vital as writing the essay itself. If it comes to writing essays in college, all of us need somewhere to begin. Furthermore, the biographical essay may present exceptional challenges to them. The Appeal of Illustration Essay Thesis All you have to do is consult with an expert customized essay writing service like ours that is guaranteed to submit all of your assigned work in time. You're able to use our papers as the ideal guides whenever you're attempting to accomplish similar works. Getting help is cheap despite what you might have heard about expert writing services. On the flip side, there isn't anything wrong with getting assistance from a very good consultant on the right outline format. In the quick prelude, give couple of examples which ought to be described in the subsequent paragraphs. It is critical to commit to paper the principal points that you are likely to discuss in introduction, body paragraphs, and conclusion. An outline is a short description or a most important point of something. Interestingly, in addition, there are cases where you are requested to take care of biography about yourself essay. Look carefully at the types of evidence the author has used to show the argument. At times, a thesis statement is widely shared, while others might be more controversial. It is usually only one sentence and is made up of the topic, focus, and three main points of the essay. It is not easy to begin your essay whenever you do not understand what it is you are handling. An essay template is a guide which ensures your approach is correct and that you don't deviate from the home purpose. Do not divert from the chief theme which you're handling. Both examples are excessively broad. Thesis writing could possibly be quite stressful. An essay template makes it possible to define the aim of your essay and stick with it. Thesis is a critical portion of every essay. An excellent thesis is argumentative and encourages the readers to take part in debate concerning the subject of the essay. The Illustration Essay Thesis Stories Below you can discover a sample essay outline structure to have a better idea about how to organize your own outline. You also need to go through the essay template to learn more on the subject of essay structure ones your outline is completed. An outline is helpful for many factors. Your outline needs to be easy and informative. Top Choices of Illustration Essay Thesis You are able to check our top-notch biographical essay example to have a glimpse of the way to organize your work. The quotes demonstrate the point you're making at that moment.
Tuesday, May 5, 2020
Journal Vascular Interventional Radiology -Myassignmenthelp.Com
Question: Discuss About The Journal Vascular Interventional Radiology? Answer: Introducation In the emergency department, establishing vascular access is the most common procedure. However, handling patients with difficult vascular access becomes a challenge for nurses. Certain conditions like obesity, vasculopathy, hypovolemia and chronic vascular access increase the likelihood of difficult vascular access. The review of research studies on interventions for difficult intravenous access has revealed that CVC (Central Venous Catheterization) is an alternative approach for the management of difficult access and achieving cannulation (Crowley et al. 2012). Although CVC helps in providing vascular access for different medical purpose, however there are many evidence which shows the risk associated with CVC cannulation. Kornbau et al. (2015) has revealed that CVC increases large number of complications in patient. Immediate complications include vascular, cardiac and pulmonary complication and some of delayed complications include catheter infection. Parienti et al (2015) also s howed that CVC is associated with infectious and thrombotic complications and catheter related bloodstream infection has negative implications on health care cost, morbidity and mortality of patient. These evidences points out to the uncertainties in management of difficult access by CVC method. However, there is also abundant evidence regarding the effectiveness of ultrasound guided venous access in increasing success rate in cannulation and decreasing complications. Hence, it would be beneficial to review PICO question based on area of practice: Population (P): Patients with suspected or known difficult venous access Intervention (I): Ultrasound-guided Intravenous access Comparison (C): Traditional techniques Outcome (O): Improved intravenous access and less complications In patients with suspected or known difficult venous access, does Ultrasound-guided Intravenous access compared to traditional technique improve intravenous access and lessen complication? Search for highest level of evidence: While looking at highest level of evidence related to the research topic, it is necessary to start from the top of the 6S pyramid. The 6S pyramid consists of systems, summaries, synopses of syntheses, syntheses, synopses of single studies and single studies (Murad et al. 2016). When seeking to find answer to the above research question, the main focus was to find highest level of evidence and then move down the list. The electronic databases that can help in getting answer to healthcare and clinical questions include Google Scholar, CINAHL, PubMed, Cochrane Library and PyschINFO (Kable, Pich and Maslin-Prothero 2012). On the basis of hierarchy of evidence, systematic reviews comes at the top of the list followed by evidence syntheses, article synopses, RCTs (Randomized Controlled Trial), Cohort Studies, case controlled studies and expert opinion (Hansen 2014). While searching relevant articles related to ultrasound guided intravenous access, the focus will be to start finding article s from highest level of evidence. To answer the PICO questions, Google Scholar, CINAHL, PubMed, Cochrane Library and PyschINFO databases were search. These databases were selected as it provides peer-reviewed articles on health care research. The search was first started with broad search terms like Ultrasound-guided Intravenous access and this was typed in Google Scholar. If the search for top two levels failed, then broad search term was also applied in CINAHL, PubMed, Cochrane Library and PyschINFO databases. For searching articles from CINAHL, PubMed and PyschINFO databases, certain specific search terms and Boolean operators like AND, OR and NOT was used. The search result was limited by limiting the search full text and peer reviewed articles. When more than one search term such as Ultrasound-guided Intravenous access and reduction in venous access complication was used, then AND or OR was used. In this way, combination of two search term was added to get relevant and highest quality evidences. After entering d ifferent combinations of search terms in databases and analyzing them according to hierarchies of evidence, three highest piece of evidence was found. One article was a randomized study by Wu et al. (2013) focusing on comparison between two-dimensional ultrasound guidance technique and land mark method in critical patient. The second article was a retrospective analysis done in emergency department Scoppettuolo et al. (2016) and the final included prospective observation study in cancer patients (Cavanna et al. 2010). Comparison of the highest level of evidence found: To effectively apply highest level of evidence to current practice in nursing setting, comparison and critical analysis of three research articles are presented below: The first randomized study by Wu et al. (2013) is considered relevant to answer the PICO question by reviewing at its title, abstract and background. The population, intervention as well as the comparator is evident from the title of the research article. It clearly showed that that real time two-dimensional ultrasound guidance technique for CVC was the main intervention and landmark method was comparator. The population of interest was also evident after reading the methodology and the outcomes of the technique was mainly evaluated in patients undergoing CVC. The landmark method compared in the RCT study also became clear after reviewing the introduction section of the article. Hence, based on this justification, the article is found relevant to answer the research question. Finding such articles specific to the research question also proves that PICO question has been appropriately formulated for clinical research and evidence based practice. Evidence has proved that formulation of clinical question by using PICO format helps in framing questions directly relevant to patient problem or clinical issue. Developing a researchable question facilitates implementing quality research and evidence based clinical practice (Aslam and Emmanuel 2010). Apart from the relevance of the article by Wu et al. (2013) in addressing research question, another attribute that resulted in the selection of this article for critical appraisal includes the position of the evidence in the hierarchy of evidence. As this assessment mainly aimed to finding out the best evidence to inform current nursing practice, taking highest level of evidence has an advantage. The hierarchical system of classifying evidence is one of the cornerstone of evidence based practice and practitioners are mainly encouraged to find highest level of evidence because maximize its effectiveness for particular intervention. The level of evidence helps to prioritize information and providing a guide to effectively evaluate results of the research (Burns, Rohrich, and Chung 2011). The article by Wu et al. (2013) has also been selected for addressing research questions because it is the highest level of evidence as it is a meta-analysis of various RCT study. The main rational fo r regarding systematic reviews and meta-analysis as being the best evidence in informing health care practice is that systematic reviews are synthesis of many good quality evidence. This helps the reviewers having time constraints to get reliable idea about the effectiveness of intervention. In case of meta-analysis, the precision of the result increases because it is a mathematical synthesis of two or more research studies (Gopalakrishnan and Ganeshkumar 2013). After reviewing the first article on the basis of relevance to the research question and hierarchy of evidence, the next goal is to evaluate the article on the basis of informing the effectiveness of ultrasound guided venous access in improving cannulation process and reducing complications. To compare and contrast real time two-dimensional ultrasound (RTUS) guidance technique with anatomical landmark method, Wu et al. (2013) retrieved randomized studies from PubMed, EMBASE, ISI Web of knowledge and OVID EMB reviews. Selection of these databases are commendable because all are updated and versatile medical databases. The methodological rigor in selecting article is seen because Wu et al. (2013) used two reviewers screened articles. One was involved in reviewing the title and abstract and other reviewed the whole article. The assessment of studies has been validated by the use of Jadad tool, which is a reliable tool to assess quality of RCT studies (Zeng et al. 2015). The impact of ultrasound techniques on puncture site, patients age and risk of cannulation failure was evaluated. The final result of the meta-analysis showed that RTUS technique reduced risk of cannulation failure in adult patient, however the same result was not found for pediatric patients. However, it reduced the risk of accidental puncture. Overall the benefits of RTUS in reducing cannulation failure incidence, accidental puncture and hematoma was proved. One significant value of this research is that it has pointed out to the changes in outcome in case of pediatric patient. Hence, while deciding to use this evidence for real pr actice, it would be essential for practitioners to assess the role of RTUS in pediatric patients or find out other approach for them. Such consideration is important in evidence based research because before implementing such evidence, there is a need to address complexity in system of care and different patient group (Hamer and Collinson 2014). The second research article that has been found to address the PICO question include the article by Scoppettuolo et al. (2016) which focused on conducting retrospective analysis for ultrasound-guided short midline catheters for difficult venous access in the emergency department. The congruence of the article to the PICO question is partly understood from reading the title of the article and partly by reading the abstract. The title gave idea about outcome and the intervention. The population of interest became evident by reviewing the background section of the article. The manner in which PICO question has helped to retrieve relevant research article also proves that PICO format is an essential tool to pursue research and explore the validity of research for application in real setting (Riva et al. 2012). On the basis of level and hierarchy of evidence, it can be said that Scoppettuolo et al. (2016) has focused on retrospective analysis comes under level II evidence for clinical studies. Burns, Rohrich and Chung (2011) have proved that for prognostic studies, retrospective analysis comes under level II of evidence. A retrospective analysis is a method that looks back at the outcome of an event that has been already established. In such cases, the data is secondary and the advantage of this method for research is that it helps to further evaluate and identify potential biasness in past studies (Smith 2015). Assessing the hierarchy of evidence is a major factor in evidence based practice and evidence based hierarchies provides the right guidance to determine the quality of evidence. This can be said because hierarchy of evidence in constructed by evaluating the research methods on the basis strength and precision in research design (Greenhalgh, Howick and Maskrey 2014). Hence, selecting research articles on by using evidence hierarchy as a guide provides the best approach to validate the quality of evidence at the first place. The usefulness of the research by Scoppettuolo et al. (2016) in terms of its applicability by nursing practice can be understood by analyzing the results of the study. The retrospectives analysis on ultrasound-guided peripheral venous access in patients admitted to emergency department in 1 year revealed that success rate of insertion of 100% and no thrombotic complications or infection was reported. On the basis of this outcome, it can be said that the research article has addressed and provided answer to the PICO question. The data based on clinical charts has convincingly proved that no complication occurred during cannulation in patient. In terms of comparison of the ultrasound guided venous access technique with traditional palpation approach, it was proved that the ultrasound guided technique was the superior method for successful venous cannulation (Scoppettuolo et al. 2016). The strength of the evidence is that the author has not only defined outcome and superiority of the te chnique, but also gave clear about the reason for positive outcome. The main reason for high success rate was that ultrasound guided technique reduced the rate of percutaneous punctures that occurred in traditional method. However, one limitation that can act as barrier in the implementation of the evidence for practice is that the study showed that success rate is dependent on characteristics of vessel. Secondly, the cost effectiveness of the method has been hampered by short duration limit for the procedure. Hence, this study points out to the need for future research in the area of addressing short duration related challenges for staffs. It also point to the need for simulation based training regarding the technique to maximize the utility of evidence for evidence based practice This points out to the need for simulation based training (Ma et al. 2011) The third article by Cavanna et al. (2010) was also found to address the PICO question and this is evident clearly by looking at the title of the article. The interventions and outcome mentioned in the title matches with the PICO question. The title is not matching the population group as the study has been done with cancer patients. However, still the research is significant to inform practice because evidence has showed that risk of complications in central venous access mainly increases in patients with chronic illness (Tapson et al. 2017). Hence, the research work on cancer patient is considered inform to inform practice in clinical setting because central venous access is necessary for all cancer patients. In terms of hierarchy of evidence, Cavanna et al. (2010) occupies the level I hierarchy as it is a prospective study (Burns, Rohrich and Chung 2011). The strength of this methodology for research is that it helps in analysis of subjects based on outcomes over a long period of time. This evidence is also found fewer biases and confounding factors compared to retrospective study. Hence, such results obtained from such study are reliable. Cavanna et al. (2010) mainly conducted the research with cancer patients requiring CVC. The Seldinger technique was used to place the catheter and 16 needle was placed under real time ultrasound guidance. Within two hours of the procedure, any CVC related complication was recorded. The outcome study done on participants for 9 years showed no bleeding and nerve puncture, however self limiting hematoma was observed. The study is found useful because it also answers the PICOT question and proves that ultrasound guidance can reduce complications in cancer patients. The strength of this evidence is that this research performed the procedure on largest number of patient thus enhancing the reliability and credibility of the result. It is the most accurate prospective trial as it has been carried out over a longer period of time. Such piece of evidence can readily applied in practice after providing some period of training to nurses. Among the three evidence, two was highest level of evidence and one was II level of evidence. In case of meta analysis and prospective study, the prospective study by Cavanna et al. (2010) is found to be the most strongest level of evidence from the three articles. This is because the methodology is free from biasness compared to other methods and analysis of outcome for long period has further enhanced the validity of the study for application in real setting. The other two studies are not reliable for application in real setting because of limitations in methodology and research outcomes as explained in sections for respective studies. Barrier to implementing EBP Among the three evidences, Cavanna et al. (2010) can be implemented as evidence based practice (EBP) in current setting because the article has clearly discussed the procedure and also addressed the limitations related to short time limit in implementing the procedure. This can be said because Seldinger technique was applied to address this shortcoming in the procedure (Goldstein et al. 2015). However, while trying to implement this evidence, certain barriers may arise in practice setting. For instance, nurses may feel reluctant to adopt the new method and abandon the traditional technique of cannulation. To address this barrier, it will be necessary to hold two or more session with nurses so that they understand the effectiveness of evidence for patient safety and reducing health care cost. This will help to address individual level barrier and changes the attitude of nurses towards EBP (Jordan, Bowers and Morton 2016). Another barrier to the implementation of EBP may include lack of time in learning about the new technique. This barrier can be addressed once the organization realize the need to change traditional practice and provide support to nurses so that they can manage their work priorities as well as attend training for effectively implementing new intervention in real setting. Such barrier can be addressed by clinical leader in organization as they can develop strategic climate for implementation of EBP (Aarons et al. 2014). Reference Aarons, G.A., Ehrhart, M.G., Farahnak, L.R. and Sklar, M., 2014. Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation.Annual Review of Public Health,35. Aslam, S. and Emmanuel, P., 2010. Formulating a researchable question: A critical step for facilitating good clinical research.Indian journal of sexually transmitted diseases,31(1), p.47. Burns, P.B., Rohrich, R.J. and Chung, K.C., 2011. The levels of evidence and their role in evidence-based medicine.Plastic and reconstructive surgery,128(1), p.305. Cavanna, L., Civardi, G., Vallisa, D., Di Nunzio, C., Cappucciati, L., Bert, R., Cordani, M.R., Lazzaro, A., Cremona, G., Biasini, C. and Muroni, M., 2010. 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