Knee Physical Therapy
Comments OffWhat is the largest joint in our body? Answer: The Knee.
The knee is the connecting point of a total of three bones in our legs: the lower end of the thigh bone or the femur, the upper end of the shinbone or the tibia, and the knee cap or the patella. Other parts of the knee are the cartilage or the shock absorbing cushions in between muscles, the tendons or the cords connecting muscles to bones, and the ligament or the bands connecting our bones to other bones. Any damage to all of these parts are accounted for by a Knee physical therapy, and just the ligament alone is so vulnerable to pulling, stretching and tearing, and with each knee having four major supporting ligaments: the anterior cruciate ligament or ACL at the center of knee, the posterior cruciate ligament or PCL also at the center, the lateral collateral ligament or LCL at the outer knee, and the medial collateral ligament or MCL at the inner knee – Oh the pains of a sprain! and much more other knee ailments. Knee physical therapy deals with damages to all these bones and parts altogether – so what better reason to take care of it!
Knee physical therapy injury prevention itself does so much in providing a better health for our knees. Being one of the most easily injured joints in the human body, the knee rightly deserves its warm- ups, before it lies fateful to Cartilage Injuries, Chrondromalacia, Tendon Injuries, Iliotibial Band Syndrome, Osgood-Schlatter Disease, Osteochondritis Dissecans, Plica Syndrome, or Arthritis.
If you are already suffering from any of these, then you should be in luck for knee physical therapy. Whether you are lying cooperatively on an injury RICE (rest, ice, compression, elevation), or just watching your way for tripping stones, whether you have knee injury or knee pain, recovering from injury, or plainly trying to avoid it – Knee physical therapy can handle it all, as long as you get it immediately.
Yes there are other procedures to hold your back beyond a knee physical therapy, yet should you go that extra mile of surgery, arthroscopy, or knee replacement? Knee physical therapy offers easy access to prevention, emergency, or rehabilitation. Following simpler processes such as evaluation, therapy, education, and aftercare, knee physical therapy can literally make you good to go. Try to jump, stand, run, and pivot – jump for joy if you have a healthy knee!
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Filed under: Occupational Health Center
Alcoholism Stages – 3 Stages of Alcoholism You Should Know
Comments OffAlcoholism stages can be categorized into three stages of alcoholism — early stage, middle stage and end stage alcoholism or late stage alcoholism. Alcoholism stages generally take years to develop. Alcoholism is a disease where alcoholic beverage consumption is at a level that interferes with physical or mental health, and negatively impacts social, family or occupational responsibilities.
Consuming no more than one or two drinks per day for healthy men and a drink a day for healthy non-pregnant women are generally considered acceptable alcohol consumption without health risks. However, as the amount or frequency of drinking increases, the earliest of the alcoholism stages can develop as a result.
Early Stages of Alcoholism
In the early alcoholism stages, a person begins to depend on alcohol to affect their mood. They drink for relief from problems, and they begin thinking more and more about alcohol. The person and others around them may not recognize that they are in the earliest of the stages of alcoholism. A gradual increase in tolerance happens, meaning, it takes increasing amounts of alcohol to achieve the desired mood-altering effects. Often, the person can consume large amounts of alcohol without appearing impaired.
In the early alcoholism stages, the body has adapted to increasing amounts of alcohol. In fact, how a person functions will likely be improved with drinking as blood alcohol levels rise. For example, they can think and talk normally or walk a straight line with no problem. However, with continued alcohol consumption over time, the body begins to lose its ability to deal with high alcohol levels. As this occurs, when the alcoholic stops drinking and their blood alcohol level decreases, their thinking, talking or walking functions deteriorate, and they are moving into the next of the stages of alcoholism.
Middle Alcoholism Stages
The need and desire to drink gradually becomes more intense. Drinking larger amounts and more often happens as well as drinking earlier in the day. The alcoholic is losing control over drinking, and the body is losing its ability to process alcohol like it did in the early stages of alcoholism. Their tolerance decreases as they become intoxicated more easily. Withdrawal symptoms begin to become more severe if alcohol is reduced.
The person may now secretly recognize there is a drinking problem, and others may begin to notice as well. Unfortunately, the alcoholic no longer can judge how much alcohol their body can handle. Typically, the drinker denies to themselves and others that alcohol is a problem so they won’t have to deal with their inner turmoil. Hangovers, blackouts and stomach problems can now be physical symptoms that occur on a regular basis.
End Stage Alcoholism
As alcoholism progresses, the alcoholic has become obsessed with drinking to the exclusion of nearly everything else. Everyone can tell there’s a major problem. During the late alcoholism stages, the mental and physical health of the alcoholic are seriously deteriorating. Many of the body’s organs have been damaged which lowers resistance to disease. Relationships at home or socially may have been severely damaged, and there can be mounting financial and legal problems due to the alcoholic’s powerlessness over alcohol.
Every alcoholic will suffer from malnutrition. Alcohol in large amounts interferes with the digestion process and the passage of nutrients from the intestines into the bloodstream. Liver function has been damaged, further limiting the conversion of nutrients into a usable form that the body can assimilate. The damaged cells are not receiving the needed nutrients, they cannot repair themselves and the damage continues. Nutritional deficiencies cause a host of related problems to become worse. For example, vitamin B-1 deficiency common in alcoholics can result in loss of mental alertness and appetite, fatigue, confusion and emotional instability.
And if the alcoholic continues drinking, alcohol will cause the death of the alcoholic in one way or another. From suicide, accidents and related injuries to direct damage to the body’s organs and systems, death will likely be the final outcome of end stage alcoholism.
Are there warning signs of alcoholism? Yes! Understand the signs and symptoms that indicate that alcohol consumption is becoming or is already a problem. There are resources available in a variety of ways to help deal with alcoholism stages and the serious consequences of this disease.
Copyright 2006 InfoSearch Publishing
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Filed under: Occupational Health Center
Excellent Way to Gain Flexibility
Comments OffFlexibility is more than the ability of the muscles to stretch, it is a prerequisite to strength, stamina and coordination. Everyone can improve their flexibility, from the high school athlete trying to prevent injuries to the senior citizen looking to improve balance (flexibility decreases with age). For the sedentary professional, occupational demands that involve long period of sitting / standing / traveling generally result in tight, inflexible muscles. In the absence of stretching techniques, a muscle sprain is very likely, even with the easiest exercise. Hence it is important to work on flexibility.
Presenting some of the easiest, do-it-anywhere ways to develop and maintain greater flexibility. You can do these exercises anywhere – when talking on the phone, on the way back home, relaxing at home, or anytime you feel like doing a minute of gentle, relaxing exercise. Even a few minutes of stretching can result in a cascade of benefits, including freedom of movement and stress release. You will soon feel lighter, energetic and more relaxed.
Tips to remember before you begin.
1. Always stretch muscles after a warm up, because stretching cold muscles can cause an injury.
2. For best results, try warming up with a simple 5 minute exercise such as on the spot marching, walking, alternate knee raises, skipping.
3. Start each stretch slowly and gently till you feel a mild discomfort (but not to the point of pain). Hold for 10 to 20 seconds.
5. Practice each stretch 3-4 times.
6. Avoid bouncing, overstretching.
There are hundreds of stretches that you can try, but the following are among the most effective.
A. NECK STRETCH-
Standing upright, slowly try to touch the chin to the collarbone, and look at the floor. Next, take your head back and try to face the ceiling; you will feel the stretch in the front of the neck region.
Benefits – helps relieve neck aches and improve posture.
B. SHOULDER STRETCH -
Stand upright with feet shoulder width apart. Clasp both hands behind the back. Slowly raise the clasped hands behind your body towards the ceiling and feel the stretch in the front of the shoulder muscles.
Benefits – helps relive stiff, painful shoulders after long hours of work
C. WAIST STRETCH.
In a standing position, reach your left arm overhead and bend to the right at the waist, allowing the right hand to slide down on the outer part of the right thigh and shin Hold. Return to the center. Repeat on opposite side.
Benefits – helps tone the waist (love handles) in addition to aerobic exercise
D. LOWER BACK STRETCH.
Stand straight, with the trunk erect, and the knees slightly bent. Bend forward, (but be careful to avoid slouching of the shoulders and upper back) and try to touch the fingertips to the floor. Slowly return to the starting position.
Benefits – helps relieve low back stiffness.
E. QUADRICEPS STRETCH -
To stretch the muscles at the front of the thigh, Stand next to a wall with the left hand leaning against the wall for support. Bend the right knee, and use the right hand to grasp the right ankle behind the body. Try to gently pull the right heel towards the bottom. Repeat on the other side.
Benefits – helps relieve tightness in the thigh, beneficial for individuals who spend long hours sitting.
For best results, try practicing these exercises after a hot shower (since warm muscles are more pliable and receptive to stretching) and / or a warm up routine to get best results.
Hopefully, these stretches can help you relieve pain and tightness. Good luck. Always stretch those muscles, and don’t neglect them when they are tight!
Filed under: Occupational Health Center
Signs and Symptoms of Substance Abuse-Overdose Assistance
Comments OffPlease keep in mind your purpose for trying to find out if someone is doing alcohol and/or drugs- To Identify and Help rather than Catch and Punish.
General: General and specific guides to detection of alcohol and drug use, and definition of addiction.
Contents:I. General Guide to Detection
II. Definition of Addiction
III. Pupil Dilation
IV. Signs and Symptoms
V. Paraphernalia a) S/S Chart Version
VI. Drug Facts
VII. Articles and Other Resources
VIII. Drug Pictures/Resources
IX. Topics
X. Additional Articles (Alcoholism, Drugs, Teenage Addiction, Interventions)
XI. Overdose and Emergency Intervention Techniques
I. Specific: General Guide to Detection
Abrupt changes in work or school attendance, quality of work, work output, grades, discipline.
Unusual flare-ups or outbreaks of temper. Withdrawal from responsibility. General changes in overall attitude. Deterioration of physical appearance and grooming.
Wearing of sunglasses at inappropriate times. Continual wearing of long-sleeved garments particularly in hot weather or reluctance to wear short sleeved attire when appropriate. Association with known substance abusers. Unusual borrowing of money from friends, co-workers or parents. Stealing small items from employer, home or school. Secretive behavior regarding actions and possessions; poorly concealed attempts to avoid attention and suspicion such as frequent trips to storage rooms, restroom, basement, etc.
II. Specific: DSM-IV Definition of Addiction
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
(1) Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
b. Markedly diminished effect with continued use of the same amount of the substance.
(2) Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for the substance
b. The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms. (
3) The substance is often taken in larger amounts or over a longer period than was intended (loss of control).
(4) There is a persistent desire or unsuccessful efforts to cut down or control substance use (loss of control). (
5) A great deal of time is spent on activities necessary to obtain the substance, use the substance, or recover from its effects (preoccupation).
(6) Important social, occupational, or recreational activities are given up or reduced because of substance use (continuation despite adverse consequences).
(7) The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (adverse consequences).
III. Specific: Pupil Dilation
Before you do anything, consider this. There are two trains of thought prior to detection and intervention. One thought is to catch and punish, and the other is to identify and help- remember why you are doing this, and the intervention will turn out much better.
Note: A 6mm, 7mm, or 8mm pupil size could indicate that a person is under the influence of cocaine, crack, and meth, hallucinogens, crystal, ecstasy, or other stimulant. A 1mm or 2mm pupil size could indicate a person under the influence of heroin, opiates, or other depressant. A pupil close to pinpoint could indicate use. A pupil completely dilated could indicate use. Blown out wide pupils are indicative of crack, methamphetamine, cocaine, and stimulant use. Pinpoint pupils are indicative of heroin, opiate, depressant use.
Other causes of pupil dilation
IV. Specific: Signs and Symptoms
Alcohol: Odor on the breath. Intoxication. Difficulty focusing: glazed appearance of the eyes. Uncharacteristically passive behavior; or combative and argumentative behavior. Gradual (or sudden in adolescents) deterioration in personal appearance and hygiene. Gradual development of dysfunction, especially in job performance or schoolwork. Absenteeism (particularly on Monday). Unexplained bruises and accidents. Irritability. Flushed skin. Loss of memory (blackouts). Availability and consumption of alcohol becomes the focus of social or professional activities. Changes in peer-group associations and friendships. Impaired interpersonal relationships (troubled marriage, unexplainable termination of deep relationships, alienation from close family members).
Marijuana/Pot: Rapid, loud talking and bursts of laughter linearly stages of intoxication. Sleepy or stupor in the later stages. Forgetfulness in conversation. Inflammation in whites of eyes; pupils unlikely to be dilated. Odor similar to burnt rope on clothing or breath. Tendency to drive slowly – below speed limit. Distorted sense of time passage – tendency to overestimate time intervals. Use or possession of paraphernalia including roach clip, packs of rolling papers, pipes or bongs. Marijuana users are difficult to recognize unless they are under the influence of the drug at the time of observation. Casual users may show none of the general symptoms. Marijuana does have a distinct odor and may be the same color or a bit greener than tobacco.
Cocaine/Crack/Methamphetamines/Stimulants: Extremely dilated pupils. Dry mouth and nose, bad breath, frequent lip licking. Excessive activity, difficulty sitting still, lack of interest in food or sleep. Irritable, argumentative, nervous. Talkative, but conversation often lacks continuity; changes subjects rapidly. Runny nose, cold or chronic sinus/nasal problems, nose bleeds. Use or possession of paraphernalia including small spoons, razor blades, mirror, little bottles of white powder and plastic, glass or metal straws.
Depressants: Symptoms of alcohol intoxication with no alcohol odor on breath (remember that depressants are frequently used with alcohol). Lack of facial expression or animation. Flat affect. Flaccid appearance. Slurred speech. Note: There are few readily apparent symptoms. Abuse may be indicated by activities such as frequent visits to different physicians for prescriptions to treat” nervousness”, “anxiety”,” stress”, etc.
Narcotics/Prescription Drugs/Opium/Heroin/Codeine/Oxycontin: Lethargy, drowsiness. Constricted pupils fail to respond to light. Redness and raw nostrils from inhaling heroin in power form. Scars (tracks) on inner arms or other parts of body, from needle injections. Use or possession of paraphernalia, including syringes, bent spoons, bottle caps, eyedroppers, rubber tubing, cotton and needles. Slurred speech. While there may be no readily apparent symptoms of analgesic abuse, it may be indicated by frequent visits to different physicians or dentists for prescriptions to treat pain of non-specific origin. In cases where patient has chronic pain and abuse of medication is suspected, it may be indicated by amounts and frequency taken.
Inhalants: Substance odor on breath and clothes. Runny nose. Watering eyes. Drowsiness or unconsciousness. Poor muscle control. Prefers group activity to being alone. Presence of bags or rags containing dry plastic cement or other solvent at home, in locker at school or at work. Discarded whipped cream, spray paint or similar chargers (users of nitrous oxide). Small bottles labeled” incense” (users of butyl nitrite).
Solvents, Aerosols, Glue, Petrol: Nitrous Oxide – laughing gas, whippits, nitrous. Amyl Nitrate – snappers, poppers, pearlers, rushamie, .Butyl Nitrate – locker room, bolt, bullet, rush, climax, red gold. Slurred speech, impaired coordination, nausea, vomiting, slowed breathing. Brain damage, pains in the chest, muscles, joints, heart trouble, severe depression, fatigue, loss of appetite, bronchial spasm, sores on nose or mouth, nosebleeds, diarrhea, bizarre or reckless behavior, sudden death, suffocation.
LSD/Hallucinogens: Extremely dilated pupils, (see note below). Warm skin, excessive perspiration and body odor. Distorted sense of sight, hearing, touches; distorted image of self and time perception. Mood and behavior changes, the extent depending on emotional state of the user and environmental conditions Unpredictable flashback episodes even long after withdrawal (although these are rare). Hallucinogenic drugs, which occur both naturally and in synthetic form, distort or disturb sensory input, sometimes to a great degree. Hallucinogens occur naturally in primarily two forms, (peyote) cactus and psilocybin mushrooms.
Several chemical varieties have been synthesized, most notably, MDA , STP, and PCP. Hallucinogen usage reached a peaking the United States in the late 1960’s, but declined shortly thereafter due to a broader awareness of the detrimental effects of usage. However, a disturbing trend indicating resurgence in hallucinogen usage by high school and college age persons nationwide has been acknowledged by law enforcement. With the exception of PCP, all hallucinogens seem to share common effects of use. Any portion of sensory perceptions may be altered to varying degrees. Synesthesia, or the “seeing” of sounds, and the “hearing” of colors, is a common side effect of hallucinogen use. Depersonalization, acute anxiety, and acute depression resulting in suicide have also been noted as a result of hallucinogen use. Note: there are some forms of hallucinogens that are considered downers and constrict pupil diameters.
PCP: Unpredictable behavior; mood may swing from passiveness to violence for no apparent reason. Symptoms of intoxication. Disorientation; agitation and violence if exposed to excessive sensory stimulation. Fear, terror. Rigid muscles. Strange gait. Deadened sensory perception (may experience severe injuries while appearing not to notice). Pupils may appear dilated. Mask like facial appearance. Floating pupils, appear to follow a moving object. Comatose (unresponsive) if large amount consumed. Eyes may be open or closed.
Ecstasy: Confusion, depression, headaches, dizziness (from hangover/after effects), muscle tension, panic attacks, paranoia, possession of pacifiers (used to stop jaw clenching), lollipops, candy necklaces, mentholated vapor rub, severe anxiety, sore jaw (from clenching teeth after effects), vomiting or nausea (from hangover/after effects)
Signs that your teen could be high on Ecstasy: Blurred vision, rapid eye movement, pupil dilation, chills or sweating, high body temperature, sweating profusely, dehydrated, confusion, faintness, paranoia or severe anxiety, trance-like state, transfixed on sites and sounds, unconscious clenching of the jaw, grinding teeth, very affectionate.
V. DRUG SIGNS & SYMPTOMS
Stimulants (Cocaine, Ecstasy, Meth., Crystal)
Depressants (Heroin, Marijuana, Downers)
Hallucinogens (LSD)
Narcotics (Rx. Medications)
Inhalants (Paint, Gasoline, White Out)
PCP
Alcohol
Note: Paraphernalia- Keep in mind, that you may not find drugs, if you are searching for them, but you can usually find the paraphernalia associated with use.
VI. Specific: Drug Facts
Includes identifiers, definitions, language of users and dealers. Drug Terms Slang and Street Terms
VII. Specific: Articles and Other Resources
This the additional information for brain chemistry and the drug user)
VIII. Specific: Drug Pictures/Resources from the DEA
CHEMICAL CONTROL
INTRODUCTION TO DRUG CLASSES
NARCOTICS Narcotics of Natural Origin
Opium, Morphine, Codeine, Thebaine
Semi-Synthetic Narcotics
Heroin Hydromorphone Oxycodone Hydrododone
Synthetic Narcotics
Meperidine
Narcotics Treatment Drugs
Methadone Dextroproxyphene Fentanyl Pentazocine Butorphanol
DEPRESSANTS Barbiturates
Controlled Substances Uses and Effects (Chart) Benzodiazepines Gamma
Hydroxybutric AcidParaldehyde, Chloral HydrateGlutethimide 7
MethaqualoneMeprobamate
Newly Marketed Drugs
STIMULANTS Cocaine Amphetamines
Methcathinone, Methylphenidate
ANORECTIC DRUGS hat
CANNABIS Marijuana Hashish Hashish Oil
HALLUCINOGENS LSD Psilocybin & Psiocyn and Other Tryptamines Peyote & Mescaline MDMA (Ecstasy) & Other Phenethylamines Phencyclidine (PCP) & Related Drugs Ketamine
STEROIDS
INHALANTS
IX. Specific: NICD Topics
Do you have questions relating to addiction /addictions / substance abuse? Contact us…Health Info and Videos Medical issues updated weekly. Family Resources for the family, intervention information, support, and counseling. Medical information, doctor and specialists directory, terminology and dictionary of terms. Treatment.
The Villa at Scottsdale- Providing a full continuum of care for the treatment of alcoholism and drug addiction.
Alcohol and Drug Addiction Survival Kit
General: A series, for the individual, family, friends, employers, educators, professionals, etc. on prevention, intervention, treatment, recovery, relapse prevention, support, and other issues relating to alcoholism and drug addiction.
1. Prevention- Includes tips on how to talk to your kids about alcohol, tobacco, and drugs.
2. Detection of Signs and Symptoms- A guide to detection of alcohol and various drug usage.
3. Definition of Addiction- A DSM-IV definition of exactly what constitutes alcoholism and drug addiction.
4. Intervention- Interventions can and do work. We will show you how to do it effectively.
5. Treatment & Housing- A treatment center and halfway house locator.
6. Support- Some guides to how to support someone while they are in treatment.
7. After Care- What to do prior to and after release from treatment.
8. Recovery / Relapse Prevention- Addiction can surface again, in the form of relapse.
9. Other Issues- Issues to think about regarding those affected by substance abuse, as well as those around them.
10. References- A list of those who contributed to this series of articles.
Articles Medical Today Dr. William Gallagher takes us through his use of DNFT with his patients. Psychotherapy Today Psychologist Jim Maclaine keeps us up to date with his articles of insight, therapy, and healing. Counseling Today Therapist Thom Rutledge gives a creative approach to dealing with life on life’s terms via his unique counseling sessions. Big Book Bytes Author Shelly Marshall shares via the Big Book on issues of concern to those in recovery. All pages are set-up to copy, for use by counselors, professionals, sponsors, and others.
Recovery Today Interviews of people in recovery, about alcoholism, drug abuse, addictions, recovery, sobriety, spirituality, wisdom, experience, strength, and hope. Tune in monthly for new articles!
A.A. History Author Dick B. will take you back to a time when the recovery rates were as high as 93%.
Journaling Today A series of informative articles by Author Doreene Clementon how, why, and what to write about.
Spirituality Today Author Carol Tuttle takes us to new heights on our spiritual journey.
Articles of God and Faith Features 100’s of topics relating to God, faith, spirituality, and more.
Life Today Everyday life experiences from people all over the world. Life, Addictions, Recovery, Hope, Inspiration, Wisdom, Advice, and so much more. Tune in on a regular basis to see what others have and are going through. Find hope from the experiences of others.
Steps Today Recovery Peer and Advisory Board Member Dean G. gives creative approach to dealing with life on life’s terms via his unique recovery sessions.
Step Work / Relapse Prevention This service is designed to assist with step work, with quotes and pages from the Big Book, with forms ready to copy and utilize. There is a section devoted to relapse prevention as well.
X. Specific: Additional Articles
Health and Medical News, videos, text from the world of medicine, health, and medical.
Ecstasy information.
How Do I Talk With My Kids About Alcohol?
How Do I talk to my kids about drugs?
How Do I talk with my teenager about drugs and alcohol?
What does a crack pipe look like?
Family assistance for substance abuse.
Addiction treatment for my teenager.
Overdose or OD Information
XI. Specific: Overdose & Emergency Intervention Techniques
Drug Overdose- Drug overdoses can be accidental or on purpose. The amount of a drug needed to cause an overdose varies with the type of drug and the person taking it. Overdoses from prescription or over-the-counter (OTC) medicines, “street” drugs, and/or alcohol can be life threatening. Know, too, that mixing certain medications or “street” drugs with alcohol can also kill.
Physical symptoms of a drug overdose vary with the type of drug(s) taken. They include: Abnormal breathing Slurred speech Lack of coordination Slow or rapid pulse Low or elevated body temperature Enlarged or small eye pupils Reddish face Heavy sweating Drowsiness Violent outbursts Delusions and/or hallucinations Unconsciousness which may lead to coma (Note: A diabetic who takes insulin may show some of the above symptoms if he or she is having an insulin reaction.)
Parents need to watch for signs of illegal drug and alcohol use in their children. Morning hangovers, the odor of alcohol, and red streaks in the whites of the eyes are obvious signs of alcohol use. Items such as pipes, rolling papers, eye droppers and butane lighters may be the first telling clues that someone is abusing drugs. Another clue is behavior changes such as: Lack of appetite Insomnia Hostility Mental confusion Depression Mood swings Secretive behavior Social isolation Deep sleep Hallucinations.
Prevention- Accidental prescription and over-the-counter medication overdoses may be prevented by asking your doctor or pharmacist: What is the medication and why is it being prescribed? How and when should the medication be taken and for how long? (Follow the instructions exactly as given.) Can the medication be taken with other medicines or alcohol or not? Are there any foods to avoid while taking this medication? What are the possible side effects? What are the symptoms of an overdose and what should be done if it occurs? Should any activities be avoided such as sitting in the sun, operating heavy machinery, driving? Should the medicine still be taken if there is a pre-existing medical condition?
To avoid medication overdoses: Never take a medicine prescribed for someone else. Never give or take medication in the dark. Before each dose, always read the label on the bottle to be certain it is the correct medication. Always tell the doctor of any previous side effects or adverse reactions to medication as well as new and unusual symptoms that occur after taking the medicine. Always store medications in bottles with childproof lids and place those bottles on high shelves, out of a child’s reach, or in locked cabinets. Take the prescribed dose, not more. Keep medications in their original containers to discourage illicit drug use among children: Set a good example for your children by not using drugs yourself. Teach your child to say “NO” to drugs and alcohol. Explain the dangers of drug use, including the risk of AIDS. Get to know your children’s friends and their parents. Know where your children are and whom they are with. Listen to your children and help them to express their feelings and fears. Encourage your children to engage in healthy activities such as sports, scouting, community-based youth programs and volunteer work. Learn to recognize the signs of drug and alcohol abuse.
Questions to Ask:
Is the person not breathing and has no pulse? FIRST AID Perform Cyprinids the person not breathing, but has a pulse? FIRST AID Perform Rescue Breathing AND is the person unconscious? FIRST AID lay the victim down on his or her left side and check airway, breathing and pulse often before emergency care. Do CPR or Rescue Breathing as needed. ANDdoes the person have any of these signs? Hallucinations Confusion Convulsions Breathing slow and shallow and/or slurring their words
Do you suspect the person has taken an overdose of drugs? FIRST AID Call Poison Control Center. Follow the Poison Control Center’s instructions. Approach the victim calmly and carefully. Walk the person around to keep him or her awake and to help the syrup of ipecac work faster, if you were told to give this to the victim. Also, see “Poisoning”. AND is the person’s personality suddenly hostile, violent and aggressive? FIRST AID Use caution. Protect yourself. Do not turn your back to the victim or move suddenly in front of him or her. If you can, see that the victim does not harm you, himself or herself. Remember, the victim is under the influence of a drug. Call the police to assist you if you cannot handle the situation. Leave and find a safe place to stay until the police arrive. AND Have you or someone else accidentally taken more than the prescribed dose of a prescription or over-the-counter medication? DO NOT perform any technique unless it is a matter of life and death! If you are unsure of what you are doing, please follow the instructions given by a 911 operator.
Note: If doctor is not available, call Poison Control Center. Follow instructions given.
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Filed under: Occupational Health Center
The HRIS Implementation Project
Comments OffCONTENTS
Introduction
a) The Project Manager
b) The Project Team
c) The Project Plan
d) Project Plan Elements:
1) Cleanse Data
2) Create Test Environment for Application
3) Employee Numbers
4) Configure Organisational Structure
5) Configure Posts (Jobs)
6) Configuring Shift Patterns
7) Configure Employee Details
Configure Users’ Access Security
9) Configure HR and Pay Rules
10) Configure Reports
11) Configure Triggers
12) History Carried Forward
13) Populating the New Application
14) Parallel Running
15) Migrate Test Data onto Live Evironment
16) Old Data
16) De-commissioning
THE PROJECT
Introduction
This is a rather more detailed look at the HRIS implementation. This has been done with the intention of giving a sense of scope and scale to the professional contemplating the acquisition and implementation of a new or replacement HRIS, and is not exhaustive, nor constitutes the ultimate Project Plan.
Most of this article deals with HR and Payroll applications, but a lot of the actions are generic to Time & Attendance systems. We shall update and expand this article from time to time to build on our visitors’ knowledge base.
Your selected Vendor will have a wealth of experience in the management of Projects such as yours, but it is useful for you to have your own appreciation of what is involved.
A lot of this material is based on real-life experience (or scar tissue!) acquired by our Team over the course of years, and we mean it to be presented in understandable language and easily-followed format.
a) The Project Manager
If there’s one message to get across here it’s DO get your own Project Manager; do NOT rely on the Vendor to project manage on your behalf as they will ultimately fail to meet everyone’s expectations, no matter how hard they work. They will always have difficulty balancing priorities that will occasionally be in conflict. You wouldn’t expect a lawyer to act as both prosecutor and defender at the same time!
Importantly, having your own person will give more ownership, and that the introduction of your new HRIS isn’t just something remote “happening to” your organisation
Let’s get this in context right away:
i) the Project Manager is unlikely to be able to combine the PM role with another day job.
ii) The Project Manager must have experience in interpreting the Vendor’s plan, marshalling (and cajoling) resources, meeting deadlines and liaising with the Vendor. It’s not a job for the amateur.
It’s very tempting for, say, an HR Manager to assume the role, but it is inadvisable unless they have the above-mentioned experience. Really – trust me on this one.
Ideally, you should use someone with the relevant experience from elsewhere within the organisation who can look at the picture dispassionately and impartially. Doing it this way, the experience stays in the organisation. Failing this, hire a professional Project Manager; it won’t be cheap, but having committed yourself to the solution you are not improving your chances of success by skimping on the essentials.
An option to reduce external costs can be to appoint a Programme Manager to oversee your Project Manager if their overall experience is not comprehensive. The Programme Manager brief will involve taking a broad view of the project, and review – probably on a weekly basis – with the Project Manager. In this way, the contractor expenditure is minimised, and the Programme Manager can provide a mentoring role.
Whoever lands the Project Manager position MUST have discretion to take decisions (within budget and other agreed limits) and have priority access to resources when required with causing unnecessary interruption to normal activities. It is essential that all affected departments are consulted during the planning of the project on all matters that affect their people and resources.
b) The Project Team
Keep the team small. Only people who have direct influence on the Project should be in the core team. Others can be co-opted for various stages of the Plan that relate to them.
A good number for the core team is 3. Beyond that, you have a committee, which will make consensus difficult and may slow matters when team members are unable to make the meetings. The more members, the more unlikely you can get everyone together on a regular basis.
c) The Project Plan
It is usual for the Vendor to draw up a project plan detailing the actions required to load, configure, implement and test the application up to purchaser acceptance and sign-off.
As the client, you will need to draw up a shadow plan to meet the case that will comprise all the steps to be taken from your side, the persons responsible for resourcing those steps and the timelines for those steps to accord with the Vendor plan.
If you do not have the (expensive) Project planning software tools for this, you can draw up your chart in Gantt format using MS Excel.
d) Project Plan elements
Below is an illustration of some typical actions in the client plan that respond to a required action in the master plan.
1. Cleanse data
Either circulate a blank form and ask employees to complete it, or print out what you have on them and ask them to correct or add information. I actually favour the former course, as it starts the data up from a zero base and means the employees have to make the effort to get it right.
2. Create Test Environment for Application
This will be your IT /ICT department that sets this up, generally by allocating a server and loading a copy of the application on to it, ready for data entry. At a later point, they will set up a Live Environment which will be the permanent home for your application.
3. Employee Numbers
Ensure that the new application can carry the sequences that you use. If you have a historical set of employee numbers, it can be a good opportunity to start from scratch
4. Configure Organisational Structure
My recommended action here is to replicate the organisation structure on the basis of the Chart of Accounts used by the Finance Department. Not only does it make the reporting understandable across the organisation, but it facilitates the smooth export of information to other applications.
Departments can be configured to carry an alpha description and the numeric Chart number as well.
Example:
And so on…
Tip No 4.1
When setting up the structure, remember to have the organisation itself at the top of the “pyramid” otherwise you will not be able to transit people between departments.
5. Configure Posts (Jobs)
A Post (Job) can be considered as the empty “suit” for a job that exists before anyone actually fills the job.
Attached to the Post will be a range of conditions:
Hours:
If standard organisational hours are 40 per week, and the Post in question, e.g. Payroll Manager, is a 40 hpw job, then it will be considered to be 1 FTE (Full-Time Equivalent) If the Post was only 30 hours per week, then it would be expressed on a headcount report as 0.75 FTE.
Grade:
Most posts will be allocated within an agreed grade. Certain benefits or conditions may automatically accrue from grades, and will need to be added to the Post accordingly.
Reports to:
This will be the immediate report in the organisational hierarchy. This has additional importance when Triggered Actions are set up, to ensure, for instance, that all employees reporting to a certain manager are advised of impending Appraisal meetings or Training Events.
The issue is a little clouded when an employee in fact holds two Posts – both perhaps part-time – and reports to more than one Manager. Some software applications cannot handle this without having two different accounts set up for the person, which is highly unsatisfactory, especially when it then impacts on the Payroll. If you have what are known as Multi-Posts in your organisation, you will have to look very carefully at your vendor specification. As a rough guide, most vendors who sell into the Public Sector will have this feature, by necessity.
Benefits:
Either dependent upon grade or perhaps as a standard feature of employment, benefits may be attached to Jobs. Theses can include Life Assurance, Permanent Health Insurance (Salary Continuation), Holidays and other Contractual provisions.
Property:
Some positions automatically require corporate property, such as Mobile Telephones, Laptops and Company Cars.
6. Configuring Shift Patterns
Most organisations will have differing shift patterns for their employees, and can range from weekly through to rotations that repeat every 12 weeks or more. Check that you have every available current shift pattern defined, and then configure them on the T&A system. After this, you will tie each employee to a shift.
Some workers are defined as “floaters” as they have no fixed patter, but you can establish a no-shift category, and the Shift Supervisors can manually add them to shifts as required.
Good quality T&A systems make setting up and editing shifts very easy indeed. A further refinement on some applications is analysis of specific work activities within shifts.
Tip No. 6.1
Sourcing a new Time & Attendance system is the right time to re-evaluate your clock-in points. The clocks represent an investment of around couple of thousand pounds each, and so you really don’t want too many of them. Study the dynamics of your operation; are your clocking points too far away from the actual work stations?
7. Configure Employee Details
Apart from routine employee information such as Name and Address, there may be a requirement to add organisation-specific fields, or to configure existing fields.
In the former group could be Fire Officers, First Aiders or Appointed Persons; in the latter will be the organisation’s required fields for categories such as Equal Opportunity Monitoring.
8. Configure Users’ Access Security
Defines who can access the application/s and to what level of information or action that they have access.
Access policies differ from organisation to organisation, but one rule should be constant: employees must not be able to change their own records (except allowed fields in Self Service environments) although they should be able to see them (Read Only) and have them included in reporting.
You may wish to allow the Training department to see employee records relating to Job and Training History, without having access to personal and salary data or in-house Recruiters to see Job detail only.
With Time & Attendance, the most common security set-up is to allow Shift Supervisors to edit their own shift workers’ absence records. Non attendance is edited in arrears when the cause for absence is known, and can then be shown as Unpaid, Sickness, Compassionate or made up later on the shift, etc.
Access issues will also arise in Time & Attendance, where the system is used for Access Control to a building or parts of a building as well as a Time Recording device.
Self Service presents a much more complex task, as you will need to organise security levels for the majority of your workforce (those who have easy access to online access). This will involve setting parameters for the fields that can be changed by all employees (address, bank details, absence and holidays), their managers and supervisors (approvals and training recommendations) and senior management (e.g. headcount, budgets and corporate communications).
9. Configure HR and Pay Rules
There are two sets of Rules: Statutory and those set by the organisation.
Statutory rules are set by Government and standard across every organisation. These will include categories such as Statutory Maternity Pay, Statutory Sick Pay, Minimum Wage and Basic Holidays.
Organisational rules are particular to that organisation and may affect Occupational provisions such as Sick Pay, Long Service Entitlements, Pay Grades and Organisational hierarchy.
As with Data Cleansing, it is never too early too early to start collecting these rules together and tabulate them. Be sure to contact the vendor for a matrix of rules that will be required so that you have a guide. Running round looking for information of this type while the vendor’s consultant has the meter running is a wasteful way to work!
10. Configure Reports
You will have to think about the variety of reports to which you will need access from the outset, what fields should appear, how they are to be filtered and if there are any time or departmental parameters. These can be used in the Report writing Training sessions, as there is no substitute in learning as doing these things for yourself!
Some examples of the most commonly used reports are:
Headcount:
Employee Number, Employee Name, Cost Centre, Full-Time Equivalent
Salaries:
Employee Number, Employee Name, Cost Centre, Annual Salary
Long Service:
Employee Number, Employee Name, Date Joined, Years’ Service (run from date of report)
Employee Turnover:
No. of employees (within given period) x 100 divided by Average Number of Employees
Stability (example shown for annual figure)
No. of employees with 1 year’s service x 100 divided by Number of Employees employed 1 year ago.
Some reports use the same building blocks and only needed to be modified, perhaps for data between two dates. You can set up two blank dates in your report (start and finish), so that when you run the report you can insert the required dates at that time. This is known in some reporting suites as Runtime Prompt.
11. Configure Triggers
Set out on paper a list of the actions of which you want notification, what triggers them, to whom notifications should be sent, and when.
For example, all new employees are on a 12 week probation period, and you want to ensure that the probation interview is carried out in a timely fashion. You configure the trigger by ensuring that the Probation rule for this employee is 3 months. You can then set the trigger to forward a formatted and mail merged email reminder to the Line Manager, the employee (and HR department, if necessary) at start date + 10 weeks.
Example:
Trigger: New Employee
Field: Probation
Condition: Start Date + 12 weeks – 2 weeks (or +10 weeks)
Action: Email
Message: “Please note that (employee name) is due for Probation review on Date (derived from the Start Date + 12 weeks). Please ensure that this review is completed by the due date.”
This is simplistic, but gives an indication of how these Triggers are constructed.
12. History Carried Forward
Payroll history is easy to manage, as only the current tax year is held live and previous data is held as an archive. These must be accessible for not less than seven years by statute, so you will need to have arrangements in place for this to comply (see Old Data).
Time and Attendance records, too, are not usually carried forward from previous holiday years. It is advisable to retain a reasonable amount of this data, perhaps 3 years, as it may be relevant to possible disciplinary action, or litigation in respect of Sickness Absence and Industrial injury.
HR records are rather more difficult to decide upon. It’s probably fair to say that the longer an employee is with an organisation, the thinner the file! The tendency is to gather more and more information about newer employees, and the trend is escalating.
Factors that should affect the amount of employee history will include:
How often do you actually refer to records more than a year old?
Does anyone ever look back at career progression over the past 10 years?
Just how accurate – and detailed – is the history?
The more history you bring forward, the more costly it becomes. Every historical post going back in time must be created, populated, and then depopulated as the employee moves on, even though the jobs, and occasionally departments, may have passed out of living memory. You are in fact reconstructing the past, and, as previously mentioned, this history may be inaccurate enough as to be of dubious worth.
An effective way of resolving this would be to agree a point in time, say 2/3 years previous to the current migration time, and import this into the new application. Earlier data can then be retained in a form of History file (see Old Data Item 15)
13. Populating the new application
Many applications are populated by uploading a series of related spreadsheets (usually.csv derived from Excel) by way of a data importer.
You can assist this process by requesting the spreadsheet templates from the vendor, and populate them from your newly-cleansed data sources. Although this is time-consuming, it is a very good sense check on the data that you have, and gives you at least a bit more ownership and control over it; you will find at times during a project that there are times that it seems like something happening elsewhere!
14. Parallel Running
It goes without saying that the most “mission critical” application is the Payroll. Whether you are moving from one application to another, or to your first computerised HRIS you will need to parallel run – that is, run it alongside your current arrangement, for a period, mainly for testing purposes to compare and validate output as well as to discover any running problems before going live.
Payroll and, to a lesser extent, Time & Attendance run more in “real time” than HR, and therefore should be prioritised.
One of the most frequent questions we are asked is “how many parallel runs should we do?” There is no hard and fast answer, and it will all depend on your resources, but we would recommend a minimum of two, and probably no more than three. If you are still encountering significant discrepancies after two parallel runs, you must quickly establish where the faults lie and correct them, otherwise your project will come unstuck.
When the parallel running and other testing is completed satisfactorily, the purchaser will then sign off an End User Testing Acceptance document. The data is then ready to be loaded in to the Live Environment.
15. Migrate Test Data onto Live Environment
This will be carried out by the IT/ICT function, and will involve decanting the validated data into the live application Environment, ready for live use.
On web-hosted applications, this will be done by the host on their own location, and the purchaser merely points their browser to the new live address.
16. Old Data
Often overlooked. As well as establishing how much history you bring forward into the new application, you still have a decision to make on where to store historical data.
Payroll is required to be accessible for no less than seven years, and HR is an ongoing record. The main options are:
Maintaining an environment version of the previous application, where records can be accessed and read;
Data converted into a contemporary format such as Excel where it can be used at will;
The old-fashioned giant pile of printout.
The first two have a cost attached; a) is usually an ongoing rental charge and b) is a one-time charge. Neither is particularly cheap. The last option is not as impractical as it might sound; people generally overestimate the amount of access they need to historical data. Providing the history reports are produced in a range of sorts (Surname, Employee Number, National Insurance Number, Operating Division) then look-ups are not time-consuming.
17. De-commissioning
Remember if you are phasing out a previous application then you will need to study the terms under which you give it up, with special regard to notice periods and financial considerations attached to them.
Existing systems should be maintained until complete cut-over to the new application is complete, and then they can be cleared down and withdrawn from the operating platform. Ensure that all master disks are accounted for are returned to the original vendor, or disposed of in line with their wishes.
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