Nursing Audit

 

D^]QBDG J^EBU

Er$(Krs$" Q$Pjiibjkkji Inaturnr AOD DBKHJDQ

 

D^]QBDG J^EBU

 

BDU]OE^AUBOD 

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Dursbdg bs j snrvban pro`nssbod$ Uhn snrvban rndenrne my dursns jrn nssndtbji to ib`n jde wni`jrn o` thn aibndts$ Uhnrn`orn thn pro`nssbod js j whoin shouie mn jaaoudtjmin `or thn qujibty ajrn enibvnrne my bdebvbeuji prjatbtbodnrs$

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Dursbdg aodanrd `or thn qujibty o` snrvban aodstbtutns thn hnjrt o` bts rnspodsbmbibty to thn pumiba$

 

BDU]OE^AUBOD… BDU]OE^AUBOD…   

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Aodanrd `or knjsurnkndt o` qujibty ajrn provbene to pjtbndts bs dot dnw) mut jafdowinegnkndt thjt qujdtbtjtbvn knjsurnkndt o` qujibty bs possbmin bs rnijtbvniy rnandt$ Uhnrn jrn bdstrukndts /toois whbah hjvn mnnd enkodstrjtne n``natbvn `or  provbebdg qujdtbtjtbvn knjsurnkndt$  knjsurnkndt$ 

 

  Hbstory o` Dursbdg Juebt Juebt 

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Dursbdg juebt bs jd nvjiujtbod o` dursbdg snrvban$ Mn`orn :2>> vnry ibttin wjs fdowd jmout thn aodanpt$ Bt wjs bdtroeuane my thn bdeustrbji aodanrd jde thn ynjr :2:8 wjs thn mngbddbdg o` knebaji juebt$ Gnorgn Growore) prodoudane thn tnrk physbabjd `or thn `brst tbkn knebaji juebt$ Und ynjrs ijtnr Uhokjs ] Sodeod KE nstjmibshne j knthoe o` knebaji juebt mjsne od proaneurns usne my `bdjdabji jaaoudt$ Hn nvjiujtne thn knebaji ajrn my rnvbnwbdg thn knebaji rnaores$

 

Hbstory…  

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@brst rnport o` Dursbdg juebt o` thn hospbtji pumibshne bd :2>>$ @or thn dnxt :> ynjrs) dursbdg juebt bs rnportne `rok stuey or rnaore tbii thn ijst enajen$ Uhn progrjk bs rnvbnwne `rok rnaore dursbdg pijd) dursns dotns) pjtbndt aodebtbod) dursbdg ajrn$  ajrn$ 

 

  Knjdbdg o` thn tnrks  tnrks  :$ Zujibty + j luegnkndt o` whjt aodstbtutns gooe or mje$ =$ Juebt + j systnkjtba systnkjtba jde arbtbaji nxjkbdjtbod to nxjkbdn or vnrb`y$ 1$ Dursbdg juebt + (j" Bt bs thn jssnsskndt o` thn qujibty o`  dursbdg ajrn (m" ^sns j rnaore js jd jbe bd nvjiujtbdg thn qujibty o` pjtbndt

 

En`bdbtbod B$

 Jaaorebdg to Nibsod -Dursb -Dursbdg dg juebt rn`nrs to jssnsskndt o` thn qujibty o` aibdbaji dursbdg-$

BB$ Jaaorebdg to to Gostnr Gostnr Wji`nr< Wji`nr< j$ Dursbdg Juebt bs jd nxnrabsn to `bde out whnthnr gooe dursbdg prjatbans jrn `oiiowne$ m$ Uhn juebt bs j knjds my whbah dursns thnksnivns ajd en`bdn stjdejres `rok thnbr  pobdt o` vbnw jde ensarbmn thn jatuji

prjatban o` dursbdg$  

Whjt bs aibdbaji juebt? ‘Aibdbaji juebt bs j qujibty bkprovnkndt   proanss thjt snnfs to bkprovn pjtbndt 

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ajrn jde outaokns systnkjtba rnvbnw o`through ajrn jgjbdst  nxpibabt arbtnrbj jde thn bkpinkndtjtbod o` ahjdgn‒  

(DBAN =33="

 

Why eo juebt? + purposns Bt ajd inje to …………$   

Bkprovne qujibty o` ajrn $  J sndsn o` pnrs pnrsodji odji jde pro`nssbodji pro`nssbodji jahbnvnkndt$ jahbnvnkndt$ Qtbkuijtbod o` Aodtbdubdg Sro`nssbodji Envniopkndt

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(ASE" Bkprovne Unjk+Worfbdg

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Bkprovne aokkudbajtbod wbthbd jd orgjdbsjtbod orgjdbsjtbod

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 J grnjtnr udenrstjd udenrstjdebdg ebdg o` thn struaturn jde proanss opnrjtbdg wbthbd thn orgjdbsjtbod Bkprovne prjatban mjsne sfbiis suah js thn bendtb`bajtbod) kjdjgnkndt jde usn o` bd`orkjtbod

 

+puposns  Why eo juebt? +puposns  

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Nvjiujtbdg Dursbdg ajrn gbvnd) Jahbnvns ensnrvne jde `njsbmin

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qujibty o` dursbdg ajrn) Qtbkuijdt to mnttnr rnaores) @oausns od ajrn provbene jde dot od

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ajrn provbenr) provbenr) Aodtrbmutns to rnsnjrah$  rnsnjrah$ 

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Whjt kjfns j gooe juebt? Gooe ahoban  ahoban   Sjtbndt andtrne  Sossbmin to knjsurn  ]nsourans jiioajtne (tbkn/`udes"  Bkportjdt  @rnqundtiy oaaurrbdg promink 

Qtjdejres jgrnne  Gooe tnjk bdvoivnkndt  Wbii mn possbmin to ahjdgn jde bkprovn

 

Soor ahoban Aibdbabjd andtrne × Dot possbmin to knjsurn × ]nsourans dot jiioajtne × ^dbkportjdt × Odiy hjppnds rjrniy × Do stjdejres jgrnne × ]nibns od odn or two bdebvbeujis × Bkpossbmin to ahjdgn nvnd b` dnnene ×

 

Uypns o` juebt  juebt  

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Orgjdbsjtbodji juebt Snnr rnvbnw

 

 Juebt bs j `ork o` pn pnnr nr rnvbnw jde bdvoivns bdvoivns j ayain o` jatbvbty js gbvnd mniow$

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Knjsurn sninatne topba 

]nvbnw stjdejres 

Uhn Juebt Ayain 

]nvbnw jgjbdst stjdejre 

Bendtb`y gjps 

Bkpinkndt jatbod 

Enaben jatbod 

 

UHN J^EBU ARAIN EN@BDN/ ]NPBNW Arbtnrbj jde Qtjdejres (Mjsne od thn mnst possbmin up to ejtn nvbendan ‑ whnrn bt nxbsts" nvbendan ‑

Bkpinkndt ahjdgn

Ensbgd Juebt Uooi 

BENDUB@R AOIINAU Ejtj od Snr`orkjdan ]naore & Jdjiysn  Jdjiysn 

Dnne `or ahjdgn Bdvoivn nvnryodn

JQQNQQ Ejtj Snr`orkjdan jgjbdst arbtnrbj & Qtjdejres 

 

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Aokkod jpprojahns  jpprojahns  Srospnatbvn rnvbnw Aodaurrndt rnvbnw ]ntrospnatbvn rnvbnw

 

vbnw  ]ntrospnatbvn vbnw 

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Uhbs rn`nrs to jd bd+enpth jssnsskndt o` thn qujibty j`tnr thn pjtbndt hjs mnnd ebsahjrgne) hjvn thn pjtbndts ahjrt to thn souran o` ejtj$ ]ntrospnatbvn juebt bs j knthoe `or nvjiujtbdg thn qujibty o` dursbdg ajrn my nxjkbdbdg thn dursbdg ajrn js bt bs rn`inatne bd thn pjtbndt ajrn rnaores `or  ebsahjrgne pjtbndts$ Wbthout suah usn o` thn rnaore) ajrn ajddot mn pnrsodjibzne) ajddot mn sj`n) jde wbii

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dot mn ahjrjatnrbzne my aodtbdubty whbah bs jd nssndtbji aokpodndt o` qujibty$ Bd jeebtbod) thn rnaore bs ingji eoaukndtjtbod o` ajrn) jde rnaores jrn jvjbijmin

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jde njsbiy jaanssbmin `or juebt$

 

vbnw…  ]ntrospnatbvn vbnw…  

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Uhn knthoe wjs ensbgdne `or usn bd hospbtjis) pumiba hnjith dursbdg jgndabns) jde dursbdg hokns mnajusn thn rnspodsbmbibtbns o` pro`nssbodji dursns `or thn ajrn o`  pnopin jrn dot jitnrne my thn snttbdgs bd whbah Bd thbsajrn typnbso`gbvnd$ juebt spnab`ba mnhjvbors jrn ensarbmne thnd thny jrn aodvnrtne bdto qunstbods jde thn nxjkbdnr ioofs `or  jdswnrs bd thn rnaore$

 

 

@or nxjkpin thn nxjkbdnr ioofs through thn pjtbndt's rnaores jde jsfs <

j$pijddbdg Wjs thndursbdg prominkajrn? soivbdg proanss usne bd m$ Whnthnr pjtbndt ejtj aoiinatne bd j systnkjtba kjddnr? a$ Wjs j ensarbptbod o` pjtbndt's prn+hospbtji routbdns bdaiuene? e$ Ijmorjtory tnst rnsuits usne bd pijddbdg ajrn? n$ Ebe thn dursn pnr`ork physbaji jssnsskndt? How wjs bd`orkjtbod usne? `$ Wnrn dursbdg ebjgdosbs stjtne? g$ Ebe dursn wrbtn dursbdg orenrs? Jde so od$

 

Arbtnrbj   Knthoe to Envniop Arbtnrbj :$ En`bdn pjtbndt popuijtbod$ =$ Bendtb`y j tbkn `rjknworf ` rjknworf `or knjsurbdg outaokns o` ajrn) 1$ Bendtb`y aokkodiy rnaurrbdg dursbdg prominks prnsndtne my thn en`bdne pjtbndt popuijtbod) 5$ Qtjtn pjtbndt outaokn arbtnrbj) >$ Qtjtn jaanptjmin engrnn o` goji jahbnvnkndt) 0$ Qpnab`y thn souran o` bd`orkjtbod$ 7$ Ensbgd jde typn o` tooi

 

Sobdts to mn rnknkmnrne< j$ Zujibtyrnspodsbmin jssurjdan kust j prborbty)j m$ Uhosn kust mn bkpinkndt progrjkkn dot odiy j tooi) a$ J ao+orebdjtor shouie envniop jde nvjiujtn qujibty jssurjdan jatbvbtbns) e$ ]oins jde rnspodsbmbibtbns kust mn enibvnrne) n$ Dursns kust mn bd`orkne jmout thn proanss jde thn rnsuits o` thn progrjkkn) `$ Ejtj kust mn rnibjmin) g$ Jenqujtn orbndtjtbod o` ejtj aoiinatbod bs nssndtbji) h$my Zujibty ejtj shouie mn dursbdg pnrsoddni jt jddujibzne jii invnis jde usne

 

Juebt bs j tnjk n``ort  n``ort 

 

Juebt Aokkbttnn  Aokkbttnn  Mn`orn ajrrybdg out jd juebt) jd juebt aokkbttnn shouie mn `orkne) aokprbsbdg o` j kbdbkuk o` `bvn knkmnrs aodsbstbdg o` Ahjbrkjd (n$g$ sndbor dursns)" jde 1+5 knkmnrs (supnrvbsors/Hnje dursns"$ who jrn bdtnrnstne bd qujibty jssurjdan) jde jmin to jrn worfaibdbajiiy tognthnraokpntndt bd j group

 

  Sroaneurn `or dursbdg juebt  juebt  

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Aokkbttnn shouie knnt odan bd j kodth to juebt rnaores o` pjtbndts ebsahjrgn eurbdg thjt tbkn$ Uhn ahjbrkjd wouie jssbgd thn dukmnr  o` ahjrts njah knkmnr wbii juebt$ Qtnps outibdne `or nvjiujtbod /juebtbdg jrn<

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Pbsbt `ork thn udbt to aokpintn thn nvjiujtbod Aokpbin thn saorn `or njah pjtbndt$ Knnt thn aokkbttnn to ebsauss thn `bdebdg$

 

Sroaneurn…$   Sroaneurn…$ 1$Knkmnrs shouie mn vnry hodnst jde bkpjrtbji bd thnbr luegnkndt$ J aod`bendtbji aod`bendtb ji dotn shouie mn sndt to thn bdebvbeuji b` soknthbdg vnry outstjdebdg hjs mnnd rnaorne$ 5$]nvbnw o` thn juebt bs eodn my thn knkmnrs o` thn aokkbttnn) aokpbine jde sumkbttne to thn juthorbtbns wbth rnaokkndejtbods `or `uturn jatbod$

 

  Urjbdbdg `or juebtors shouie bdaiuen thn `oiiowbdg j$ J entjbine ebsaussbod ebsaussbod o` thn snvnd snvnd aokpodndts$ m$group J group ebsaussbod ebsa ussbod to snn how thn rjtns t hn ajrn rnanbvne usbdg thn dotns o` j pjtbndt who hjs mnnd ebsahjrgne) thnsn shouie mn jdodykous jde shouie rn`inat j totji pnrboe o` ajrn dot nxannebdg two wnnfs bd indgth$

 

Urjbdbdg…$   Urjbdbdg…$ 

Njah bdebvbeuji juebtor shouie thnd udenrtjfn thn sjkn nxnrabsn js jmovn$

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Uhbs bs `oiiowne my j knntbdg o` thn whoin aokkbttnn who aokpjrn jde ebsauss bts `bdebdgs) jde `bdjiiy rnjah j aodsndsus o` opbdbod od njah o` thn aokpodndts$

 

  Qtnps to promink Qoivbdg Sroanss bd Sijddbdg Ajrn <  <  j$ Aoiinats pjtbndt ejtj bd j systnkjtba kjddnr  :$ bdaiuens ensarbptbod o` pjtbndts prn+ hospbtji routbdns) =$ hjs bd`orkjtbod jmout thn snvnrbty o`  biidnss) 1$ hjs bd`orkjtbod rngjrebdg rngjrebdg ijm tnsts) 5$ hjs bd`orkjtbod rngjrebdg vbtji sbgds) >$ Hjs bd`orkjtbod `rok physbaji jssnsskndt nta$

 

  m$ Qtjtns dursns ebjgdosbs) a$ Wrbtns dursbdg orenrs) e$ Quggnsts bkknebjtn jde iodg tnrk gojis) n$ Bkpinkndts thn dursbdg ajrn pijd) `$ Sijds hnjith tnjahbdg `or pjtbndts) g$ Nvjiujtns thn pijd o` ajrn)

 

Juebt js j Uooi `or Zujibty Aodtroi   Aodtroi

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 Jd juebt bs j systnkjtba systnkjtba jde o``babji o``babji nxjkbdjtbod o` j rnaore) proanss or jaaoudt to nvjiujtn pnr`orkjdan$  Juebtbdg bd wbth hnjith ajrn orgjdbzjtbod org pr ovben kjdjgnrs j knjds o`jdbzjtbod jppiybdg provben aodtroi proanss to entnrkbdn thn qujibty o` snrvban rndenrne$ Dursbdg juebt bs thn proanss o` jdjiyzbdg ejtj jmout thn dursbdg proanss o` pjtbndt outaokns to nvjiujtn thn n``natbvndnss o` dursbdg bdtnrvndtbods$

 

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  Outaokn juebt  juebt  Outaokns jrnhnjith thn nde rnsuits ajrn6 ahjdgns bd thn pjtbndts stjtus jdeo`ajd mnthn jttrbmutne to enibvnry o` hnjith ajrn snrvbans$ Outaokn juebts entnrkbdn whjt rnsuits b` jdy oaaurrne js rnsuit o` spnab`ba dursbdg bdtnrvndtbod `or  aibndts$ Uhnsn juebts jssukn thn outaokn jaaurjtniy jde enkodstrjtn thn qujibty o` ajrn thjt wjs provbene$

Nxjkpin o` outaokns trjebtbodjiiy usne bts to knjsurn qujibty o` hospbtji ajrn bdaiuen kortjibty) kormbebty)

jde indgth o` hospbtji stjy$  

  Sroanss juebt  juebt  

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Sroanss juebts jrn usne to knjsurn thn proanss o` ajrn or how thn ajrn wjs ajrrbne out$ Sroanss juebt bs tjsf orbndtne jde `oaus od whnthnr or dot prjatban stjdejres jrn mnbdg `ui`biine$ Uhnsn juebts jssukne thjt j rnijtbodshbp nxbsts mntwnnd thn qujibty o` thn dursn jde qujibty o` ajrn provbene$

 

Qtruaturn juebt  juebt  Qtruaturn juebt kodbtors thn struaturn or  snttbdg bd whbah pjtbndt ajrn oaaurs) suah js thn `bdjdans) dursbdg snrvban) knebaji rnaores jde ndvbrodkndt$ Uhbs juebt jssukns thjt j rnijtbodshbp nxbsts mntwnnd qujibty ajrn jde jpproprbjtn struaturn$ Uhnsn jmovn juebts ajd oaaur  rntrospnatbvniy) aodaurrndtiy jde prospnatbvniy$

 

@or thn n``natbvn qujibty aodtroi) thn dursn kjdjgnr hjs to pijy `oiiowbdg roins jde `udatbods$ :$ Jppibajtbod jde nxnautbod o` physbabjd's ingji orenrs =$ Omsnrvjtbod o` sykptoks jde rnjatbods 1$ Qupnrvbsbod o` thn pjtbndt 5$ Qupnrvbsbod o` thosn pjrtbabpjtbdg bd ajrn >$ ]nportbdg jde rnaorebdg 0$ Jppibajtbod Jppibajtbod o` dursbdg proaneurns jde tnahdbquns 7$ Srokotbod o` hnjith my ebrnatbod jde

 

tnjahbd $

Jevjdtjgns o` Dursbdg Juebt  Juebt   usne js j knthoe o`  Ajd mn 

knjsurnkndt bd jii jrnjs o` dursbdg$ 

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Qnvnd `udatbods jrn njsbiy udenrstooe) Qaorbdg systnk bs `jbriy sbkpin)

]nsuits njsbiy udenrstooe)  Jssnssns thn worf o` jii thosn bdvoivne bd rnaorebdg ajrn$

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Ebsjevjdtjgns o` thn Dursbdg  Jpprjbsns Juebt  Juebt   thn outaokns o` thn dursbdg 

proanss) so bt bs dot so usn`ui bd jrnjs whnrn thn dursbdg proanss hjs dot mnnd 

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bkpinkndtne) Kjdy o` thn aokpodndts ovnrijp kjfbdg jdjiysbs eb``bauit) Bs tbkn aodsukbdg) ]nqubrns j tnjk o` trjbdne juebtors) Enjis wbth j ijrgn jkoudt o` bd`orkjtbod) Odiy nvjiujtns rnaore fnnpbdg$

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Bt odiy snrvns dursbdg ajrn$ to bkprovn eoaukndtjtbod) dot

 

  QOKN BQQ^NQ B QQ^NQ BD B D NPJI^J NPJI^JUBDG UBDG UHN Z^JIBUR O@ D^]QBDG AJ]N  AJ]N 

Uhny jrn< Wbthout thbs `oudejtbod stodn) thn struaturn o` qujibty jssnsskndt ajddot ajddot mn mubit$ Hjvbdg jaanptne rnspodsbmbibty `or thn qujibty o` ajrn) thnrn stbii rnkjbds j 

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enabsbod jmout thn invni jde saopn o`  jgnday aodanrd$ Odn kjy ebstbdgubsh snvnrji stnps bd j progrnssbod o` wbendbdg aodanrd$

 

:$ Uhn ajrn provbene my j spnab`bne pro`nssbodji group (bd thbs ajsn) dursbdg" bd j pjrtbauijr jgnday$ jgnday$ =$ Uhjt portbod o` pjtbndt ajrn provbene my j pjrtbauijr jgnday) bdaiuebdg thn aodtrbmutbod o` jii pro`nssbodjis bdvoivne bd thn ajrn o`  jdy gbvnd pjtbndt$ 1$ Uhn totji ajrn o` jdy gbvnd pjtbndt brrnspnatbvn o` thn souran o` ajrn$ 5$ Uhn provbsbod o` hnjith snrvbans `or thn aokkudbty (hownvnr en`bdne" js j whoin$

 

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Bt bs dnanssjry to nxpibabtiy spnab`y thn invni i nvni jde saopn o` aodanrd mnajusn thn jspnats o`  ajrn thjt rnqubrn jssnsskndt kjy vjry `rok invni to invni jde so kjy thn knthoes mnst subtne `or thnbr jssnsskndt$ @or nxjkpin) thn engrnn o` jaanss to ajrn bs jd aodanrd jt whnd thn aokkudbty invni6 bt bsnssndtbji kuah inss rninvjdt thn qunstbod jsfne bs whnthnr j pjtbndt jirnjey udenr  ajrn rnanbvns qujibty dursbdg$

 

Uhnrn jrn j snt o` bssuns thjt aodanrd thn sninatbod jkodg jvjbijmin jpprojahns to nvjiujtbod$ Odn kjy aijssb`y thnsn jpprojahns udenr thrnn hnjebdgs< struaturn)proanss) jde outaokn$

 

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Uhn nvjiujtbod o` proanss aodsbsts bd thn jpprjbsji o`  thn ajrn btsni`$ Uhn dursbdg juebt bs jd nxjkpin o` thbs jpprojah$ Bt bs dot sjtbs`bne wbth thn knrn prnsukptbod o` qujibty bd jdy spnab`bne snttbdg$ Bt sumlnats to pro`nssbodji  luegkndt thn ninkndts jde entjbis o` ajrn$ Bt puts to jatuji tnst thn jssukptbods thjt anrtjbd struaturji ahjrjatnrbstbas jrn rnijtne to anrtjbd invnis o` pnr`orkjdan$ o` pnr`orkjdan$ Uhn nvjiujtbod o` outaokns aodsbsts bd thn jssnsskndt o` thn nde rnsuits o` ajrn+usujiiy spnab`bne bd tnrks o` pjtbndt hnjith) wni`jrn) jde sjtbs`jatbod$ Uhn nxtndt to whbah jgrnne+upod ensbrne outaokns

jrn jahbnvne bs thn uitbkjtn tnst o` thn jssukptbods  

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Uhn ebstbdatbod mntwnnd proanss jde outaokn bs) to sokn nxtndt) jd jmstrjatbod$ Mntwnnd thn bdbtbjtbod o` ajrn jde bts tnrkbdjtbod thnrn jrn j dukmnr o`  aokpintne tjsfs(-proaneurji nde pobdts-" jde stjtns o` thn pjtbndt (-bdtnrknebjtn outaokns-" thjt ajd mn usne js bdebajtors o` thn qujibty o` ajrn$

 

   J wnii+roudene systnk o` qujibty jpprjbsji jpprjbsji wouie promjmiy bdaiuen aodaurrndt or  aoorebdjtn jssnsskndts jssnsskndts o` struaturn) proanss) jde nde rnsuits) to thn nxtndt thjt njah o` thnsn bs omsnrvjmin jde knjsurjmin udenr thn aodstrjbdts bdhnrndt bd jdy gbvnd snttbdg$

 

Bssuns   Qokn Unahdbaji Bssuns 

Uhnrn jrn j dukmnr o` tnahdbaji prominks jde bssuns bd thn dursbdg juebt thjt ajd mn odiy mrbn`iy kndtbodne$ :$ Uhn ]naore js j Qouran o`  Bd`orkjtbod+ Odn omlnatbod to juebts) whnthnr knebaji or dursbdg) bs thjt thny jssnss thn qujibty o` thn rnaore rjthnr thjd thjt o` thn ajrn jatujiiy

provbene$  

Qfbii`ui rnaorebdg kjy gbvn j `jisn bkprnssbod o` qujibty) jde okbssbods `rok thn rnaore kjy aodvny j `jisn bkprnssbod o` poor ajrn$ Uhn rnaore bs) o` aoursn) jd bdebspndsjmin tooi o` pjtbndt kjdjgnkndt jde bt bs pnr`natiy ingbtbkjtn to nvjiujtn thn qujibty o` rnaorebdg$

 

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Uhn eoumts thjt jrn ajst od thn rnaore js

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j trun kbrror o` thn ajrn jatujiiy provbene jrn promjmiy nxjggnrjtne6 mut thny hjvn dnvnr mnnd `uiiy nrjsne$

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Uhnrn j dukmnr o` prnajutbods kjy mnjrn tjfnd to kbdbkbzn possbmin thjt kbsrnprnsndtjtbod my thn rnaore$ Uhn kost bkportjdt jrn to envbsn jpproprbjtn rnaores) to nd`oran rnjsodjmin rnjsodjmin stjdejres o` rnaorebdg) jde to jiiow `or ebsaussbod o`  thn `bdebdgs wbth thn pnrsod who hjs

provbene ajrn$  

=$ En`bdbtbods) Arbtnrbj jde Qtjdejres+ Bt bs nxtrjorebdjrbiy eb``bauit to en`bdn whjt qujibty bs$ Pnry promjmiy qujibty bs dot j hokogndnous propnrty mut j ijrgn mudein o` ahjrjatnrbstbas$ Anrtjbdiy aibndts) physbabjds) jde dursns kjy ioof `or eb``nrndt ahjrjatnrbstbas js sbgdb`bnrs o`  qujibty jde/or wnbght thnk eb``nrndtiy eb``nrndtiy$$  Js j prniuen to jdyjtnvjiujtbod bt bs dnanssjry dnaaodanrdbdg nssjry)) thnrn`orn) to jrrbvn sokn jgrnnkndt whjt jspnats o` ajrn jrn to mn js jssnssne snssne jde od whjt aodstbtutns -gooednss- bd njah jspnat$

 

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Arbtnrbj jde stjdejres jrn bkpibabt bd jdy  luegkndt o` qujibty$ qujibty$ Uhn nxtndt to whbah thnsn jrn kjen nxpibabt kjy kjy)) hownvnr) vjry$ Qokn juthorbtbns bd knebaji juebts `jvor nxpibabt `orkuijtbod o` arbtnrbj jde aodsbenrjmin spnab`babty bd stjdejres$ Othnrs `jvor j korn udstruaturne jpprojah bd whbah nxpnrt luegns jrn sbkpiy gubene my how thny thnksnivns wouie hjvn kjdjgne j gbvnd pjtbndt$

 

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1$Qajins jde Knjsurnkndts+Qokn Knjsurnkndts+Qokn nxjkbdnrs hjvn j prn`nrndan `or ovnr+jii rjtbdgs wbth j kbdbkuk o` ebvbsbods suah js -gooe)-gooe)- -`jbr -`jbr))- or or -poor$-poor$Othnrs hjvn jssbgdne duknrbaji saorns to ninkndts o` ajrn jde aukuijtne thnk to jrrbvn jt jd ovnr+jii duknrbaji rnprnsndtjtbod rnprnsndtjt bod o` thn qujibty o` ajrn$ Uhn dursbdg juebt bs jd nxjkpin o` thn ijttnr  jpprojah$

 

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@or nxjkpin) trnjtkndt enpndes od jdtnanendt ebjgdosbs$ Bd nxtrnkn ajsns)pnr`orkjdan bd odn ninkndt kjy mn so mje thjt bt ajddot mn aokpndsjtne `or my nxaniindan bd othnr  ninkndts) jde thn ajrn kust mn rjtne -poor$Qnaode) bt bs eb``bauit to en`nde thn wnbghts (whnthnr nquji or udnquji" thjt jrn jssbgdne to eb``nrndt aokpodndts or  ninkndts o` ajrn$

 

5$Pjibebty jde ]nibjmbibty+Wn ]nibjmbibty+Wn hjvn jirnjey suggnstne thjt thn vjibebty o`  thn jssnsskndts o` proanss ajd mn tnstne my entnrkbdbdg thn outaokns o` ajrn

 

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Uhnrn bs rnjsod to mnibnvn thjt rnjsodjmiy rnibjmin luegkndts ajd mn omtjbdne through thn juebt o` knebaji rnaores$

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Bt bs jiso aijbkne thjt rnibjmbibty bs bkprovne my thn prbor spnab`bajtbod spnab`bajtbod o`  arbtnrbj jde stjdejres$

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Dnvnrthninss) korn jttndtbod dnnes to mn gbvnd to nstjmibshbdg rnibjmbibty bd thn jssnsskndtt o` pjtbndt ajrn$ jssnssknd

 

Qokn Opnrjtbodji Bssuns  Bssuns  

:$

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Uhnrn jrn j dukmnr o` bssuns thjt pnrtjbd to thn bkpinkndtjtbod o` pro`nssbodji ajrn juebts bd gndnrji$ Who Qhouie Aodeuat Uhnk jde `or Whjt Surposn ?+ Uhnrn bs gndnrji jgrnnkndt thjt njah pro`nssbod bs soiniy aokpntndt to luegn thn qujibty o` ajrn provbene my bts knkmnrs$ Hownvnr)) js thn aodanrd mrojends to bdaiuen thn Hownvnr totji ajrn o` bdebvbeuji pjtbndts bt wbii mnaokn dnanssjry to envniop knthoes thjt rnqubrn lobdt

jssnsskndt my rnprnsndtjtbvns o` snvnrji  

  =$J snaode qunstbod bs whnthnr thn juebts shouie mn bdtnrdji) aodeuatne my jgnday pnrsoddni) or nxtnrdji) aodeuatne my pnrsods `rok outsben thn jgnday thjt bs udenr nxjkbdjtbod$ Uhnrn bs sokn nvbendan to suggnst thjt nxtnrdji juebtors tnde to mn korn arbtbaji thjd jrn bdtnrdji juebtors

 

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Hownvnr) nxpnrbndan hjs showd thjt moth bdtnrdji jde nxtnrdji juebts ajd mn n``natbvn$  J -kbxne- juebt aokkbttnn aokkbttnn js proposne my Kbss Shjdnu` kjy aokmbdn thn jevjdtjgns o` moth$ Uhn purposns o` thn juebt jrn rnaogdbzne to mn prbkjrbiy neuajtbodji jde aodstruatbvn rjthnr  thjd pudbtbvn or enstruatbvn$ Qokn juthorbtbns hjvn suggnstne thjt thbs prn`nrrne orbndtjtbod mn bdstbtutbodjibzne my aod`bdbdg thn jdjiysbs to thn bendtb`bajtbod o` 

pnrvjsbvn pjttnrds o` jgnday pnr`orkjdan$  

=$ Bkpinkndtjtbod jde 

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UhnrnN``natbvndnss hjs mnnd rnkjrfjmiy ibttin stuey o` thn N``natbvndnss    jmbibty o` pro`nssbodji juebts to mrbdg jmout ijstbdg ahjdgns bd pro`nssbodji mnhjvbor$ Uhnrn hjvn mnnd jdnaeotji jaaoudts o`  rnkjrfjmin suaanss jde o` omlnat `jbiurn6 mut ibttin bs fdowd jmout thn t hn abraukstjdans thjt entnrkbdn suaanss or `jbiurn$ Uhnrn bs urgndt dnne `or stuebns o` thn pro`nssbodji juebt prbkjrbiy js j aokpinx soabji proanss rjthnr thjd knrniy j tnahdbaji promink o` knjsurnkndt$

 

1$ Aost) jde Aost bd ]nijtbod to N``natbvndnss+   N``natbvndnss+ 

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Ejtj od thn aost o` juebts jrn jikost dodnxbstndt$ Dor jrn thnrn jdy ejtj od aost bd rnijtbod to n``natbvndnss o` juebts or o` jitnrdjtbvn knthoes o` jpprjbsji$ Quah stuebns jrn surniy dnnene$

 

  Aodaiusbod   Aodaiusbod  J pro`nssbod aodanrds `or thn qu qujibty jibty o` bts snrvban aodstbtutns thn hnjrt o`  bts rnspodsbmbibty to thn pumiba$  Jd juebt hnips hnips to ndsurn ndsurn thjt thn thn qujibty o` dursbdg ajrn ensbrne jde `njsbmin bs jahbnvne$ Uhbs aodanpt bs o`tnd rn`nrrne to js qujibty jssurjdan$