Social Marketing Plan Essay Example | Topics and Well Written Essays - 2000 words

Social Marketing Plan - Essay Example So it is fair to say that the success of the company is not only in the number of customers but also in the use of social media (Drell, 2011, p. 123). Through adequate study on the impact of social media in marketing strategy, the company has formed its own guideline for controlling the interaction between the company and its customers. The Coca-Cola Company presence in social media is, therefore, incredibly vital in engaging its customers in the company’s operations and in facilitating constructive conversation between the company’s management and other stakeholders in the market (Coca-Cola, 2012, p. 37). The essay below therefore seeks to expound on the advantages and disadvantages of using social networking plan in Coca-Cola Marketing strategy. Coca-Cola brand is a highly valued brand in beverage and food industry. The brand is commonly known for its community involvement as well as its high sales in global market. On the other hand, to continue its dominance in glob al market, Coca-Cola Company has in the last two years actively involved itself in various social media platform. The company’s engagement in social media platform has as a result formed the bases for the company’s social marketing plan. ... In these two promotion strategies, the two teams were expected to use social media platforms such as YouTube Face-book and Twitter to identify what makes people happy in the world and to document the occurrences of the trip. Participants in the two activities used Face book and Twitter to express their experiences. The respondents’ comments were as posted in the Coca-Cola Face-book and Twitter pages Advantages To start with, the 2010 social marketing plans in Coca Cola Company proved to be very effective in the company’s internal and external operations. Internally, the use of social media tools triggered effective communication between the marketing team, communication department, and public relationship team (Katz, Blumler and Gurevitch, 2004, p. 509). Productive communication between the three teams led to the creation of an effective marketing strategy which has so far helped the Coca-Cola brand to be one of the most competitive products in global market. The compan y’s current marketing strategy has incorporated customers’ opinions and suggestions. The communication department has the mandate of updating the company’s social site and transferring the posted feedbacks to the department of public relation and marketing for action. Externally, the two promotion strategies were as well successful in linking the company to its customers. The two campaigns strategies helped the company contact more than 650 million customers in a span of 12 months. Most of the contacted customers created a very close link with the Coca-Cola brand thus advancing the brand reputation in global market. On the other hand, the two plans also demonstrated the involvement of

Compare two of the regional human rights systems, analyzing the Essay

Compare two of the regional human rights systems, analyzing the similarities and differences in their respective approaches to the protection and promotion of human rights - Essay Example They are the precursors of normative frameworks. They form the minimum standards that a member state has to adhere to while enacting their municipal law must conform to these standards. This means that in any case a country seeks to enact a municipal dealing with a matter that is covered under any human right system, then that country needs to use the standard set in that particular human right system as the benchmark. There are three main human rights systems in the world; the European Human Right System, the Americas Human Rights system and the African Human right system. For the purposes of this paper, the comparison shall be focused on the European and the African Human Rights system. The choice of the two is influenced by the fact that the European Human Right system was the first to develop while the African human right system is the last to develop. Another motivation for choosing these two systems is derived from the fact one is established in the developed region while the other is developed in a developing region. Despite the existence of the African Human rights system there is still a high level of human rights violation. It is important to note that each of these human rights systems developed out of influences and forces unique to the nations involved. These systems developed at different times and were triggered by different reasons. It is also imperative to note that each of these three systems has specific and tailor -made solutions and means to ensure that the specific rights of a certain group of people is catered for. The matters that led to the development of the European Human Right system were influenced by the World War II. On the other hand, the African Human Right system was triggered by other factors the main one being colonialism. Robertson (1982) propounds that the belief by the European nations that in order to secure democracy human rights had to be respected. The East Europe as well as the Western

Goldman Sachs Fraud Case Research Paper Example | Topics and Well Written Essays - 2000 words

Goldman Sachs Fraud Case - Research Paper Example Goldman Sachs Fraud Case Introduction Goldman Sachs defrauded investors by failing to reveal the apparent conflict of interest on mortgage investment it floated as the housing market became sour. The charges that were brought forward by the Securities Exchange Commission against Goldman Sachs argued for unlawful action and fraud in the trading of toxic subprime mortgage derivative securities. Nevertheless, Goldman Sachs affirmed that they were merely following normal business practices and had not committed any wrong. The Goldman Sachs fraud case elicited critical issues centering on the inadequacy of the investment banking practices, and raised the question whether it is a case of deceptive or unethical behavior (Craig & Scannell, 2010). The three-month legal ordeal erased close to $20billion of the firm’s stock-market value. A lively public discussion that followed the charge of Goldman Sachs by SEC centered on whether Goldman Sachs, broadly viewed as an embodiment of bubble -era greed, was also a lawbreaker. Questions emanated on whether Goldman bankers warranted condemnation for deliberately exploiting the naivety of investors to gain from the trading of debt instruments that were bets on a market Goldman Sachs was doomed to collapse (Whalen & Bhala, 2011). Although the transaction entailed in the SEC’s lawsuit can be regarded as small by Goldman Sachs’ standards, its arrangement alludes to weighty questions regarding the fault of the banks in driving up a market within mortgage-derived securities that lingered practically inclined to self-destruction (Buell, 2011). The SEC was asking whether Goldman Sachs gained from both sides in a way that contravened their fiduciary obligation to their customers. The SEC claimed that investors essentially lost over $1billion dollars and that Paulson’s short option debt instrument on the credit instrument derived a profit of more than $1billion (Jones, 2010). Email traffic pointed out that Tour re plus others were aware of the subprime mishap as early as January 2007 before the crisis became full blown. The SEC sought a restriction, disgorgement of profits, and sanctions with regard to interest and civil monetary penalties (Craig & Scannell, 2010). In addition to these charges, criminal prosecutors were exploring whether Goldman Sachs or its employees committed securities fraud with regard to the firm’s mortgage trading. #1 The Fraud Goldman’s case entailed four forms of securities that all played some roles amid the 2008 financial downturn: first, the residential mortgage-backed securities (RMBS) embodying a form of security derived from pooling of mortgages on residential real-estate into bonds; a credit-default swap (CDS) representing a form of insurance policy; a collateralized debt obligation (CDO) representing a debt security collateralized by debt obligation; and, synthetic CDO’s (SCDOs) equivalent to ordinary to ordinary CDOs excluding that inv estors own CDOs on real securities rather than the real securities themselves. The Securities and Exchange Commission (SEC) filed a civil fraud charge against Goldman Sachs & Co, as well its vice presidents for fraud for misrepresenting information meant for investors by misstating key facts regarding a financial product connected to subprime mortgages at a moment when the housing market within the United States started to crumble and lose value (Buell, 2011).  

Corporate risk management Essay Example | Topics and Well Written Essays - 1500 words

Corporate risk management - Essay Example Each region or country has their own rules and regulations to be followed. There are many additional features like giving financial protection against theft of the vehicle or possible damage to the vehicle. It is illegal for any person to run their vehicle in the road without any motor insurance. Most of the jurisdiction are applied both to the drivers well as to the car, though degree of severity varies. There are many countries where there is a scheme like â€Å"pay-as-you-drive†. Here the driver has to pay the premiums through the gasoline tax that he uses. Using this both the problem get solved, one like charging the uninsured motorists and another is to charge them based on the number of miles. This increases the efficiency of the insurance through streamline collection. But associated with it is the risk of insurance companies charging higher premiums than others. But being a compulsory thing, the motor man sometimes faces the risk of paying higher insurance in cases if he doesn’t get any options. Discussion The manager here owns a fleet of motor vehicles. The problem here is that the motor insurer has given them a premium quotation which appears to be high to them. Hence the manger has to look for alternative course of action. The manager must look for other motor insurance provide. The manager must know what the options available to him in the market are, like he can go to any brokerage house where there is a number of insurance provider tied up with them. Manager must understand the features offered by the insurance provider (Frenkel, Dufey, Hommel and Rudolf, 2005, p. 543). There are several basic features which he needs to look at. Like the Liability Only Policy. This type of insurance policy covers the liabilities of insure towards third parties only. It is mandatory for the each and every vehicle which runs in any the public place as per the Motor Vehicles Act of any country. Next important step is the Package Policy. This states that for any loss or any damage to the vehicle insured it will be covered subject to the terms and conditions to the policy. The manager must understand that premiums are calculated on various factors like type, usage, model, place of registration, past claims of history etc. of the vehicle under consideration. Hence the approach should be known to him (Vinnem, 2007, p. 32). He must understand that while buying a fresh new insurance during the renewal he can go for other companies who provide the insurance. The manager must also know that if the premium is charged too high he can go to the insurance provider and ask for the exact details of the components where the money is being charged high. He must mention whether the vehicle runs on Gas or on Petrol because each of them will have a different cost attached to it (Khatta, 2008, p. 241). Hence the manager should understand the fact that there is a risk of moving from one insurer to another new insurer. For any new client the motor car insurance provider will check what is the vehicles damage, what is the cc of the car and accordingly quote the premium. But it might happen that government may increase tax rate which is applicable to the motor insurance. And as a result the premium may again rise (Merkin and Smith, 2004, p. 387). Hence the manger has to consult many insurance providers at the same time and assess the risk by discussing with them. There are many steps to assess the risk. First step is to identify hazard, here the managers must know

Images of Millay's emotional state in What lips My Lips Have Kissed Essay

Images of Millay's emotional state in What lips My Lips Have Kissed - Essay Example Upon reflecting on her past love affairs, there were some images that helped her convey her emotional state. Specifically in line three and four stated that â€Å"Under my head till morning; but the rain (line 3) Is full of ghosts tonight that tap and sigh (line 4)† suggests that the speaker had to spend the rest of the evening without the presence of a loving mad. Line seven and eight stated that â€Å"For unremembered lads that not again (line 7); Will turn to me at midnight with a cry (line 8)† expresses the idea that the speaker had for several times experienced crying because of misunderstanding with a man. The reason why she feels the way she does is because of her past recent summer relationship which has ended for no reason at all. In line with this, the speaker’s recent summer relationship was clearly indicated in line thirteen and fourteen of the poem stating that â€Å"I only know that summer sang in me (line 13); A little while, that in me sings no more (line 14)†. Although the speaker does not clearly reflect any forms of bitterness or regrets, line six of the poem which stated that â€Å"And in my heart there stirs a quiet pain† suggests that the speaker is emotionally hurt was because of the last summer love she had with a man. All this made her think about her past relationships that never worked the way she

Subsidiary Ledgers and Special Journals Essay Example for Free

Subsidiary Ledgers and Special Journals Essay A subsidiary ledger is a ledger that includes all of the details of a general ledger, and it holds accounts with similar attributes. The purpose is that is can contain things such as accounts receivable and accounts payable and it can show the sum total. The advantages of using subsidiary ledgers is that the sum of all the accounts is kept in the General Ledger and all of the details of the accounts are kept in the subsidiary ledger which is separate so you can keep them in different columns so to not get confused. A control account is an account that contains the total number of sales/purchases made. If you add up all of the individual accounts it should equal the control account, also known as a summary of the account. The purpose of a control account is that it doesn’t have to contain all of the details but it will have all of the financial information organized accurately. The accounts receivable and accounts payable ledgers are two general ledger accounts that act as control accounts for a subsidiary ledger. Cash receipts journal, cash payments journal, sales journal, and the purchase journal are the four different special journals of accounting. The advantages of all the journals are that transactions that occur on a daily basis can be put into a specific journal and one person can be in charge of that journal. All of the information can be tracked in one place which can make the work much easier as well. A cash payments journal can be used with any company that deals primarily with cash which is most companies. A cash receipts journal is sometimes used for the sales of a product to help track transactions. Purchase journals are used with companies that make a lot of purchases on one account while sales journals are for companies that perform purchases. The sales journal posts the sum on the general ledger at the end of the pay period/month.

Wound care essentials summative assignment

Wound care essentials summative assignment Module Code: Wound Care Essentials Section 1. Search strategy Describe the strategy you used to retrieve the right resources to help you write your assignment. You must include the key words you used, the sources of your literature, the years searched and the type of literature you were looking for. Harvard (2007) stated that a well-structured literature search is an effective way to get reliable evidence on the topic being searched. The intended sources that will be use are healthcare databases, systematic review libraries and specialist organisations. In searching, keywords were created using Boolean logics AND, OR, NOT and phrases with quotations. The following are the list of keywords: Foot ulcer* CINAHL- retrieved 1842 records -COCHRANE lib retrieved 3 records PubMed retrieved- 1770 records diabetic foot ulcer* CINAHL- retrieved 844 records COCHRANE 2 records Cochrane reviews PubMed 46 records diabetes mellitus* CINAHL 54940 records PubMed 32863 records COCHRANE 0 record diabetic neuropathy* CINAHL 1003 records PubMed 802 records COCHRANE 0 IJDDC 76 records assessment tool* AND diabetic foot ulcer* CINAHL 24 results PubMed 2 results COCHRANE 0 International Journal of Diabetes in Developing Countries 0 manage* AND diabetic foot ulcer* CINAHL 216 results PubMed 24 results COCHRANE 0 IJJDC 0 manage* OR intervention* AND diabetic foot ulcer* CINAHL 224573 results PubMed 24 results COCHRANE 1131 results IJJDC 0 prevalence AND diabetic foot ulcer*- CINAHL 64 results PubMed 9 records COCHRANE 0 record IJJDC 11 records treatment* OR intervention* AND diabetic foot ulcer* CINAHL 316806 PubMed 33 records COCHRANE 39911 records IJDDC 5 records cost* AND diabetic foot ulcer* CINAHL 97 records PubMed 4 records COCHRANE 0 evidence base* AND diabetic foot ulcer* CINAHL 73 records PubMed 1 record COCHRANE 0 care guideline* AND diabetic foot ulcer* CINAHL- 3 records COCHRANE 0 PubMed 0 Eligible studies were identified by searching the Cochrane Library (November 8, 2010), Cochrane Wound group (2000 to November 1st week 2010), PubMed (2000 to November 1st week 2010), EBSCO CINAHL plus (2000 to November 2nd week 2010). Furthermore, reliable websites and links were used also such as www.intute.ac.uk, www.boperis.ac.uk, www.dh.gov.uk, www.library.nhs.uk, Wound Care Alliance, World Wide Wounds Electronic Journal, the Tissue Viability Society, and the International Journal of Diabetes in Developing Countries or www.ijddc.com. Peer reviewed and published journals were used which are reliable and reviewed by other authors. There was no restriction on language of publications. All publications were no more than 10 years old. Section 2. Wound aetiology Select a common wound type (e.g. diabetic foot ulceration, pressure ulcer, leg ulcer, fungating wound, dehisced surgical wound), which you have cared for in your role as a qualified nurse. It may help to reflect on a patient you have cared for with this type of wound. Using contemporary literature to support your work, discuss: What your chosen wound type is How this type of wound develops (including contributory factors) How this type of wound is recognised (common characteristics) Who it affects Prevalence in UK and home country Approximate word count: 800 _______________________________________________________________________________ Your answer here: One of the common types of wounds is diabetic foot ulcer. International Working Group on the Diabetic Foot (2010) defined diabetic foot ulcer in their research system as a full-thickness penetration of the dermis of the foot in a person with diabetes. According to Jeffocoate and Harding (2003) diabetic foot ulceration is a common complication of diabetes and it is disabling and frequently leads to leg amputation. It usually occurs as a result of neuropathic, vascular changes of a diabetic foot, foot deformities, plantar callus and smoking (NICE, 2010). Even though the cause of diabetic peripheral neuropathy is uncertain, it is known that the nerve function of a diabetic patient degenerates in response to metabolic changes, pressure and ischaemia (Alexander, Fawcett Runciman, 2000). On the other hand, the presence of high sugar level in the blood such as sorbitol can cause osmotic swelling and subsequent damage to the nerve cell, increase the risk of vascular disease and can also give rise to neuropathy and increase the risk of infection (Falanga, 2005; Watkins, 2000). Pendsey (2010) stated that the neuropathy in diabetic patients is manifested in the motor, autonomic and sensory components of the nervous system. In motor neuropathy, the innervations of the intrinsic foot muscles are damaged that leads to an imbalance between flexion and extension of the diabetic foot. It also affects the muscles required for normal foot movement altering the distribution of forces during walking. This creates anatomic foot deformities that make abnormal bony prominences and pressure points and causing skin reactive callus at the sites of abnormal load. It then gradually causes skin breakdown and ulceration (Pendsey, 2003). In sensory neuropathy, it affects the peripheral sensation, subsequently loss of sensation that makes the patient unable to feel trauma to their lower extremities. Patient will also feel heaviness, insensitivity to heat, cold and pressure. It is estimated that 45-60% of all diabetic ulcerations are due sensory neuropathy (Frykberg, Zgonis, Armstrong et al., 2006). According to Alexander et al (2000) when mechanical forces continue to be applied on the affected area, it leads to inflammation, abscess formation and, eventually, ulceration. This is also the reason many wounds go unnoticed and get worse progressively since the affected area is continuously subjected to repetitive pressure and shear forces from ambulation and weight bearing without noticing it. In autonomic neuropathy the peripheral nerve function is affected, which controls the distribution of blood through arteriolar vessels. One of the signs and symptoms is decreased perspiration in the lower extremities which make the skin becomes dry and increasingly prone to fissures (Alexander et al. 2000). Moreover, poor blood supply to the foot or ischaemia is another significant risk factor for diabetic foot ulceration, which according to Frykberg et al. (2006) it often occurs in combination with loss of sensation and the researchers also said that an estimated 45% of diabetic ulcers are due to ischaemia and neuropathy. Diabetic foot ulcer is commonly found in areas where the abnormal pressure distribution arises from disordered foot architecture. It is usually located on hallux, first metatarsal and fifth metatarsal heads, and under the heel (Grey, Enoch Harding, 2006). The precipitating causes of foot ulceration and infection are friction in ill fitting or new shoes, untreated or self treated callus, foot injuries, burns, corn plaster, nail infections and heel friction in patients confined to bed (Watkins, 2003). According to International Working Group on the Diabetic Foot (IWGDF) diabetes is global epidemic with devastating human, social and economic consequences. The disease claims many lives and places a severe burden on healthcare systems and economies everywhere, with the heaviest burden falling on low and middle income countries such as Philippines. It is estimated that 250 million people worldwide have diabetes, equating roughly 6% of the adult population with the age group 20-79 years. The number is expected to reach about 380 million by 2025, representing 7.1% of the adult population. This is due to the current lifestyles which is lack of exercise and not having a proper diet. A survey conducted by Morgan, Currie, Smithers, Butler and Peters (2000) revealed that foot problems occur in nearly 20% of diabetic patients. Two-thirds of lower extremity amputations are performed in diabetic patients alone, and a majority of these are preceded by a foot ulcer. Nwabudike and Ionescu-Tirgoviste (2008) set out a study to identify the clinical parameters associated with foot ulceration in diabetic patients. The study suggested that older age diabetic patient poses the risk of developing foot ulcer because of decreased ability to self care, including personal daily foot examinations. This is also a result of poor vision and impaired mobility which also predispose patients to trauma. The study also shows that most patients with ulcer were type 2 diabetic patients and this correlates with the age of the patient group. The average duration of diabetes the patients have was of 11.5 years. It is twice more common in males may be due to the active nature of the activities th at men are engaged compared to women, increasing the likelihood they may suffer from trauma. In Nwabudike (2008) research, it also showed that lack of awareness of the disease process and personal care increasing the likelihood that the ulcers may degenerate and leads to gangrene and amputation. Section 3. Wound Assessment Identify features of your chosen wound aetiology (wound type) that are commonly identified during the assessment process. Now select one of these features and critically discuss different ways of assessing this problem. You must link your discussion to the contemporary wound care literature. Here is a list of wound features commonly identified during assessment: Odour Exudate Infection Wound bed tissue e.g. slough, necrotic tissue Your discussion must make clear which aspect of wound assessment you have chosen and include an exploration of the different options available for measuring, describing and documenting it. Approximate word count: 500 Your answer here: Accurate wound assessment is essential for the appropriate and realistic planning of goals and interventions for patients with wounds (Collier, 2003). Diabetic foot wound has two classifications, the neuropathic foot ulcer and neuroischemic foot ulcer. Differentiating between these entities is essential because their complications are different and they require different therapeutic strategies (Pendsey, 2007). Neuropathic wound has no sensation and foot is warm to touch with intact pulses. The ulcerations are usually located on tips of toes and plantar surfaces under metatarsal heads. It also shows oedema, local necrosis and sepsis. On the other hand, ischaemic ulcer is painful upon rest and usually diminished sensation over period of time. Moreover, the foot is not warm to touch and has no pulse. The ulcerations are often located on margins of foot especially on the medial surface of the first metatarsophalangeal joint and over the lateral aspect of the fifth metatarsophalangeal joint. They also develop on the tips of the toes and heels. Signs of sepsis, necrosis or gangrene are also noted. An established clinical tool TIME which is adapted from Watret (2005) is being used for assessing the wound bed. The acronym stands for tissue, infection, moisture balance and advancing or undermining epithelium. Necrotic tissue, slough and eschar are non-viable tissues that can be found on diabetic ulcer that needs to be removed through debridement while the presence of epithelial tissue and granulation tissue in the wound suggests healing. The unhealthy granulation tissue often dark in colour and frequently bleeds on contact are signs of infection. Moisture in the wound bed needs to be assessed too. Moist is known to stimulate healing by promoting granulation and encouraging debridement, nevertheless, moisture balance should be maintained to prevent the wound from becoming too dry and too moist which could delay wound healing. In addition the wound edges and environment will be assessed for migrating epithelial cells which is a good sign of healing or maceration which suggest poor care. Infection is a major factor that affects the time healing of all wounds. Jeffcoate and Harding (2003) said that infection can cause substantial deterioration and delay wound healing. Infection is an invasion and growth of pathogenic microorganisms in the body. Diabetic foot infection is divided in three categories: superficial and local, soft tissue and spreading or cellulitis, and osteomyelitis (Jeffcoate Harding, 2003). The classic signs of infection are: heat, redness, swelling and pain. Other signs such as increase exudates, delayed healing, odour, and abnormal granulating tissue are also suggesting infection (Grey et al, 2006). Cutting et al (2005) and Edmonds (2005) used a checklist for identifying infection in diabetic foot ulcers. In the checklist, there are four areas; under it are the signs and a box opposite to it to check if certain signs are present. Clinical signs of infection: Cellulitis- acute inflammation of tissue lymphangitis phlegmon- purulent exudate pus/abscess crepitus in the joint erythema increase in exudates volume localised pain malodour probes to bone. Systematic signs of infection: Nausea Fatigue Vomiting Fever chills Probe to bone test: bone palpated no bone involvement Wound culture: wound swab required wound biopsy required. Furthermore, the wound infection continuum of Gary, White, Cooper and Kingsleys (2005; 2010) is also use to measure the extinct of infection. It is also a useful adjunct in identification of treatment objectives. The scoring is from 3-0; score of 3 means spreasing infection and 0 is colonised. Moreover, Gray et al (2010) also have the wound exudates continuum; it identifies presence of infection since excessive exudates suggest infections. Section 4. Wound Management Using the same wound feature that you identified in Section 3; critically discuss the different ways there are of managing this problem. Your discussion must include: The different types of wound care dressings, products and treatments that could be used to manage this problem Other appropriate/related aspects of patient care such as nutrition and positioning How the patient experience can be improved Now select one of your identified dressings and answer the questions in the product information table below: Product information table Name of dressing (the company name) AQUACEL Ag Hydrofiber (Convatec, Hull, UK) Category of dressing (the generic name) Hydrofiber Wound Dressing with Ionic Silver Indications for use Use on acute and chorin wounds, including burns, surgical wounds, diabetic foot ulcers, pressure ulcers, and leg ulcers Contra-indications Aquacel Ag Hydrofiber should not be used on individuals who are sensitive to or who have had an allergic reaction to the dressing and its components such as Na Carboymethylcellolose and silver. Its not compatible with oil-based products, such as petrolatum jelly. Sizes available 2x 2, 4x4.7, 6x6, 8x12, 75x18, 39x18 Adhesive or non-adhesive? Non-adhesive dressing Secondary dressing needed required Moisture retentive dressing such as DuoDERM Extra Thin or Versiva Approximate word count: 1000 Your answer here: Management of diabetic foot ulcers are removal of callus, eradication of infection, and reduction of weight bearing forces, often requiring bed rest with the foot raised (Alexander, Fawcett Runciman, 2000). A large proportion of patients with diabetic foot ulceration will develop infection, including osteomyelitis or bone infection and gangrene (OMeara et al, 2006; McIntosh, 2007). An infected diabetic ulcer needs immediate medical attention. Jude (2007) stated that infection is a major factor that delays wound healing of a diabetic ulcer. It may be necessary to undertake surgical debridement and drainage of pus. Then a wound swab will be taken from the floor of the ulcer after the callus has been removed. A culture of the excised tissue may provide more accurate information (Watkins, 2003). This will help identify the infective microorganisms and the appropriate antibiotic therapy to be given (Alexander et al., 2000). According to Watkins (2003) patients with superficial ulcer infection can be treated with oral antibiotics such as amoxicillin, flucloxacillin and metronidazole. Since the most likely organisms to infect superficial ulcer are staphylococci, streptococci, and sometimes anaerobes. For patients with deep infections should be hospitalised and started on broad-sprectrum antibiotics. Surgical debridement should then be carried out, which should include all the devitalised tissues, sloughed tendons, and infected bones. Jude (2007) said that diabetic foot ulcers generally have multiple organisms isolated from within the wound and methicillin-resistant Staphylococcus aureus (MRSA) is an important vancomycin and teicoplanin can be given to patients infected with MRSA. Anyhow, linezolid can be an alternative which can be administered orally. Furthermore, various topical antimicrobials, antiseptics, and antibiotics have been used also in treating infected diabetic foot ulcer. Topical antibiotics like neomycin, bacitracin, neomycin, gentamycin, polymyxin B, mupiricin, fusidic acid, and topical antiseptics are also used in infected foot ulcers. Although antiseptics and antibiotics are widely used, there is insufficient evidence for their use in diabetic foot ulcers (Jude, 2007). Lipsky, Holroyd Zasloff (2008) studies showed that pexiganan cream can be used as an effective alternative to oral antibiotic therapy in treating mildly infected diabetic foot ulcer and might decrease the risk of selecting antimicrobial-resistant bacteria. Dressings also play an important role in managing infected diabetic foot ulcers. There are various dressings available in the market nowadays. The selection of a dressing will depend on the condition of the ulcer. Most infected diabetic foot ulcers produce copious amount of exudates and pus. Dressings are used to control exudates, maintain a moist wound healing environment and eradicated the microorganisms that cause infection. The appropriate dressings for infected wounds with exudates are foam, alginates, hydrofiber, and hydrocolloids that are combined with silver ion. Silver has been shown to have bactericidal properties and has been used in wounds as an antimicrobial for more than century. It acts by impairing the bacterial electron transport system and some of its DNA function. It kills the microbes on contact through multiple mechanism of action, such as inhibiting cellular respiration, denaturing nucleic acids, and altering cellular membrane permeability. Nowadays, Silver ions have been incorporated in hydrofiber, foam, hydrocolloid, and alginate dressings (Bergin Wraight, 2006). Concreet Foam dressings with silver can be used during inflammatory phase following debridement and desloughing. It also kills microorganisms on the wounds. It is very absorbent that can be left undisturbed for 3-4 days. However, it can cause a drying effect on the wound if there are too little exudates. Hydrofiber dressings such as Aquacel Ag absorb the exudates, protecting the edges of the wounds from maceration at the same time kills the bacteria in the wound. Alginate dressings is use as a primary dressing and for packing wound, it is good for deeply ulcerated wound with high exudates. Another dressing is hydrocolloid; it is best use on wounds with granulating and epithelialising wounds that with low to moderate amounts of exudates. The primary dressings therefore should be either foam-based such as Contreet foam (Coloplast;Humlebaek, Denmark) or hydrofiber AQAg (Aquacel Ag; Convatec, Chester,UK), both of which will absorb the exudates. A moisture retentive dressing can be used as a secondary dressing such as DuoDERM Extra Thin or Versiva. One advantage with the hydrofiber dressing is its capacity to hold wound exudates and microorganisms within its fibres where the bacteria are then eradicated by the ionic silver (Jude, 2007). In addition, the used of hydrofiber dressing in exudating wounds has been proven with research. Jude also implied to improved outcomes in infected diabetic foot ulcers and ulcers that are colonised, one should consider silver dressings as an essential adjunct to wound care to improve its wound bed and to facilitate healing. Studies also revealed that patients treated with AQAg primary dressing showed improved healing and more overall ulcer improvement with less deterioration in the ulcer. Once the acute situation has resolved it will be necessary to ensure redistribution of the weight-bearing forces on the vulnerable foot by the use of specially constructed shoes or moulded insoles. Application of a total contact plaster cast, lightweight scotch cast boot, or air cast boots may help healing. These conform to the contours of the foot, thereby reducing shear forces on the plantar surface. Great care must be taken, especially with the fitting of plasters, to prevent chafing and subsequent ulcer formation elsewhere on the foot or ankle (Watkins, 2003). If recurrence of neurophatic ulceration is to be avoided, regular follow-up by a chiropodist will be required. An ongoing podiatry to remove excess callus and provide nail care regular assessment, look for active lesions and treat immediately, detect and manage deformities, callus, skin cracks, and discoloration, simple sensory test, examine pulses such as dorsalis pedis and posterior tibial, assess ankle reflex and assess other sensory modalities (Alexander, Fawcett Runciman, 2000). The patients experience will be improved by having a highly structured care. The patients infected ulcer shows healing improvement and prevent from amputation. Understanding the diabetic foot, the proper examination of the patients feet, investigations to classify the foot ulcers, and proper management techniques using a team approach, along with preventive steps, will go a long way in limb salvage and prevention of foot amputation (Pendsey, 2010). Section 5. Evidence based guidance Identify a contemporary source of evidence based guidance (i.e. a clinical guideline) which could be used as a basis for providing a high standard of care to patients with this type of wound. Critically discuss how the guidance given in this document might influence your nursing practice including whether you believe there are any omissions or recommendations made that would be difficult to manage in your own clinical setting (Phillipines). You must clearly state the full reference of your chosen guideline document and link your work to other healthcare literature where appropriate. Approximate word count: 500 Your answer here: