#Abstract Merp

[bearcatart]

THE USS TREE SPARROW is the most pathetic ship in Starfleet. With a clumsy, nonsensical nepo baby Captain, a crew composed entirely of troublemakers/unpleasant officers, a formerly scrapped starship model, extremely uncomfortable uniforms, and a bridge tortoise, the Tree Sparrow is shoved on a mission to locate nonhumanoid life in the galaxy - and sent to deep space. Character info under cut.

From LEFT to Right, top to bottom:

Captain Abstract Merp, 45, Merp She/her cisgender bisexual woman. The daughter of the first Merp fleet admiral in Starfleet, and a lover of animals. Extremely clumsy. Got her name because she only talks in abstract/poetic/nonsensical sentences, which T'Via translates into "normal" speech for as her best friend and first officer. Has a pet tortoise that lives on the bridge.

First Officer T'Via, 39, Vulcan, She/her. Cisgender bisexual woman. The only person who knows at first that Starfleet fucking hates Abstract and feels sort of bad for her, despite that being Illogical. She plays 57 instruments and loves poetry.

Dr. Quin Diaz, 29, human, he/him, bisexual trans man. He is the ship counselor and he loves to sculpt!! He has a HUGE crush on Beatrice that he cannot really hide. He also spends a lot of time helping Clover calm her mental instabilities, they're very good friends.

Science Officer Beatrice Glass, 32, she/her, human, heterosexual trans woman. Was a clown before Starfleet Academy (no literally). Faithful co-member of Xorienne's comedy club. Generally all around the coolest. Best friends with Xorienne.

Chief Engineer Leklo, 35, he/him, Aenar, bisexual cisgender man. He's telepathic, but hates using that power. He's kind of a nerd about Earth culture, but incredibly reserved socially. A total genius though. Loves to write. Has a pet cat. Sometimes sleeps with T'Via.

Ensign Clover V'Lyty, 21, Human-Caitian, nonbinary lesbian, she/her. Abstract's lover and the ships xenoveterinary specialist, a child prodigy who was fast-tracked through Starfleet Academy due to her intellect. She is incredibly mentally unstable but tries her best to be calm. She has enhanced hearing.

Chief Medical Officers Kal & Vrinna, 35 & 32, Marlenn - original species, she/her for both. Part of a species that conjoins with their lovers, Kal and Vrinna met in Starfleet as the only Marlenn at the academy, both in medical, and fell in love. Their kind are tricksters by nature, so they love to gossip and prank, but are extremely serious about their jobs. They bicker like an old married couple and can communicate telepathically. Leklo finds it difficult to be around them due to them having two minds and him being telepathic.

Security Chief Xorienne, 34, they/them, Bolian-Betazoid. A huge stoner and way too relaxed. Doesn't take their job seriously AT ALL. Polyamorous. Runs a comedy club on the Tree Sparrow. Loves a good board game and the holodeck. Has limited empathic powers.

[alienhybrids]

thalassa, adult, it/zhe. this is my oc blog; it is mostly fandom ocs, mostly star trek, the orville, babylon 5, and other science fiction, but i do my own OW stuff sometimes too!

main OC groups I'll be talking about here: the U.S.S. Tree Sparrow (Star Trek) & U.S.S. Gloster Canary (The Orville)

my favorite OCs are captain abstract merp & ensign clover v'lyty from the u.s.s. tree sparrow project!

i love lesbians i love aliens i love love

i dont get what a dni is but my stance on life in general is "do whatever you want forever unless it harms someone irl" so do with that what u will. im here to talk about my ocs not fight

links: artfight /// toyhou.se // ao3

[tesslahey]

pretty boy- rafe cameron

pairings: rafe cameron x fem!reader

warnings: fluff

a/n: this just came to me so i wrote it down. short lil blurb bc im bored and dont feel like sleeping. i hope u like it. also school has been fucking exhausting so i cant upload that much merp:( #howdoitellmyparentsiwanttodropoutandbecomeafulltimefanfictionwriter

*DISCLAIMER- I say chick-fila a lot, its a fast food chain, if you don’t know it, I’m sorry, I’m just sorry for you.*

kissy

-tess

masterlist

You and Rafe have been dating for a few months now, so you were still in the beginning phase of your relationship. You wouldn’t say it was the honeymoon phase, because you struggled with anxiety and Rafe has been struggling with addiction for a while now. 50% of your relationship was comforting each other.

However, these days were your favorite. You would pick up Rafe after school and drive around, without a destination, just enjoying each others company. Driving was your only escape from your mind, so you spent, a lot of time in the car. And Rafe didn’t mind, in fact, he found it cute the way you looked so relaxed and care free. 

He thought you were the most beautiful person he’d ever seen. Being a rich kid with daddy’s money, lots of girls flocked toward him, normally with the intention of reaping the benefits of his wealth. However, you weren’t like that. You often talked about how you thought money was a pointless idea to measure the worth of humans, and Rafe could listen to you speak on things you were interested in for hours. 

You rolled down the windows as you neared tanny hill, while blaring your favorite music at the moment. Rafe closed the door to his house, or “estate” to be technical, and headed toward your black jeep wrangler. Bug. That was the name you gave your car. You didn’t have an explanation as to why that was the name. It just came to you. 

“Rafael” that was your greeting for Rafe, and when you greeted him in any other way, he always assumed you were mad at him. 

“Y/n/n, looking delightful as always.” he replied while shutting your door. 

“So I was thinking we pick up chick-fila and drive as far as bugs will take us before she can’t breath, then we hitch-hike home. Sound like a plan?”

“I can’t think of anything I would like more. Except a new girlfriend maybe.”

“Watch your mouth Cameron. You loose aux privileges after that one.”

You both buckled your seatbelts and left off for your unknown destination. Chick-fila first of course. 

Your playlist was very, abstract, as Rafe liked to call it. In one car ride, you went from Adele, to Asap Ferg, to One Direction, to the Beatles. 

The first song to come on was Jesse’s Girl. Rafe your chapstick as a microphone while singing, horribly, but definitely singing. You couldn’t help but laugh at the boy.

You picked up your chick-fila, ordering 2 extra orders of fries, for the road of course. Rafe leaned over the center console to ask for barbecue sauce, which baffled you. After you pulled away from the ordering microphone, you turned your head in disgust.

“Did you really just ask for barbecue sauce from chick-fila.”

“Yeah why”

“How could you order barbecue sauce when chick-fila sauce exists. I might have to break up with you right now. That is a red flag I can’t ignore.”

“Chick-fila barbecue sauce is elite, no discussion.”

“Yeah whatever I’ll remember this.”

You got your food and ate your road fries. One of your favorite songs came on, Chasing Pavements by Adele. You belted the song at the top of your lungs. Rafe always told you that your voice was too good to ignore, but singing was your escape. You didn’t want it to be anything other than that. And he was probably biased anyway. 

You drove to a lookout to finish your food. You brought blankets and laid them out to stargaze, one of your favorite past times. You always loved astrology, and could talk about it forever. Rafe had his arm wrapped around you while you rested your arm on his chest. You occasionally looked up at him, and he would lean down and peck your lips, then your nose, and finally your forehead. 

In that moment, you wished you could take a picture, and show the whole world that this is the Rafe Cameron that you love. Not the disappointment of a son, or the unavailable brother, or the rich kid coke addict, but the sweet and loving person that he is. 

You dozed off to the sound of his heart beating under you. The next thing you knew, he was carrying you to the car. He put the blanket on top of you and put the top on the wrangler, because it got colder once the sun went down. He got in the drivers seat, and drove away from your secret hideout. 

You woke up when you were about 20 minutes from Kildare. You yawned and stretched at much as you could in your car. 

“Good morning love” Rafe said while looking down at you and smiling.

‘Eyes on the road Cameron.” You replied in your sleepy voice. 

He just laughed at relaxed into his seat. You couldn’t help but stare at him. How his messed up hair flowed in front of his hair. How the moonlight gave his eyes a watery look. He looked so pretty. 

“Take a picture, it’ll last longer.” he commented. And you took your phone out and snapped a picture before he could react. 

“I didn't mean literally.”

“well now I can look at it forever. your a pretty boy you know that right Rafael?

He looked surprised by the comment. He wasn’t used to the feminine compliment, since his dad made him feel like anything feminine was weak. But in that moment, he felt strong. 

Like he had everything he’d ever want. And she was sitting next to him.

a/n- JNDJNWNR#UN i rlly love this so very much and im passing away now. this is my dream relashionship right here. BYE LOVES i dont know you but i love you.

[natural-singularity]

tagged by @gayandrewminyard ty bud <3

Nicknames: Maddie/Mads

Zodiac: Aries ☉ Pisces ☽ Cancer ↑

Height: 5′4″

Hogwarts House: Slytherin

Last Thing I Googled: ‘Code Lyoko Netflix’ because OMG ITS ON NETFLIX YALL i had to google to confirm

Song Stuck in My Head: Dynamite and Blood, Sweat, and Tears are dukin it out in my mind ://

Number of followers: 538

Amount of sleep: i slept in ‘til noon but i don’t remember when i fell asleep. but probably 10 hours! after getting 5ish hours a night during the work week it felt goOooOd

Lucky Number: 14

Dream Job: some kind of academic advising/student support position. or, i have very abstract ideas about becoming an LMHC

Wearing: gray tshirt, undies, smart watch, old glasses. its called fashun sweaty

Favorite Song: ive absolutely said this before but it always jumps to mind, Two Fingers by Jake Bugg

Aesthetic: comfy, casual, constantly in a state of exhaustion✌🏻

Favorite Author: i havent been reading enough to have a solid definite all-time favorite but in the last few years ive really really loved ngozi ukazu she’s doin some super cool stuff

Favorite Animal Noises: the little merp/meep from a kitty omg

Random: why was the grape sunbathing? no raisin really ¯\_(ツ)_/¯ 

i’m tagging @vampirebuckley @edgarallanrose @ghostlyreggie @gracieli @madamewriterofwrongs @adamngoodbuck @ediediaz and anyone else who wants to play :))

[taperwolf]

The first TTRPG I picked up was D&D; I played BECMI for a little bit, and then late 1st edition AD&D. But the second TTRPG I picked up was Middle-Earth Role Playing (MERP), which bolted its Tolkien license to a stripped-down version of Rolemaster.

Now, in 1e AD&D, experience points are pretty simple: for each gold piece you carry home, you get 1 XP. It's a useful abstraction for the intended dungeon crawl. But a lot of early competitors thought this too hand-wavey, besides rewarding you twice for the same thing, so experience points got more complex; MERP/Rolemaster, as per its usual, went for baroque. You get points for wounds you deliver, points for killing (or incapacitating) an enemy, points for casting spells in combat, points per mile traveled in unfamiliar terrain, and on and on.

But the reason I bring this up here is because MERP also gives you points for each hit point of damage you take in a combat — as long as you aren't healed while combat is ongoing. Definitely a "school of hard knocks" idea here. And Rolemaster goes the extra mile — if you take a wound that would be fatal, but are then healed, you get half the XP someone would get for killing you; if you're actually killed and then brought back in some manner, you get double. Because that's certainly (an) experience!

(The first edition of the Rolemaster rules uses terminology that is concerning; a lot of the XP explanation uses the term "player" where you'd really expect "character". It's merely confusing when the rules tell the GM to award points based on how far the player traveled or how many power points they used to cast a spell, but downright worrying when you get text like "If the player was given a normally mortal wound...")

I love it when a video game monster’s entire purpose is to blow itself up in your face and inflict massive damage, and when it does its thing the game gives you XP for it as though you’d defeated it.

I mean, I guess it was a learning experience.

[wallpaperpainting]

How I Successfuly Organized My Very Own Diy Sunset Painting | diy sunset painting

Following is a archetype of the video.

Caroline Aghajanian: Actuality are four accessible DIY methods to actualize attach art on yourself. Try ombré or acclivity nails with a architecture sponge, bespatter nails with a toothpick or a blockhead pin, assorted attach designs appliance band to actualize stencils, and a tie-dye or marble architecture appliance artificial wrap. Here’s how it works. And actuality she comes. Wow.

[cameras clicking]

Boom, boom, boom, boom, boom, boom. It’s a home salon. Welcome to Caroline’s Attach Parlor. I got my sponges, I got my attach colors, I got some absolutely beautiful attach colors. This is gonna be fun. The coffee has absolutely hit. Aboriginal I’m activity to try accepting ombré nails with a architecture sponge. Aah! There you go, got my dusk nails! The blot technique, you get the adhere of it, but do, like, a little bash and again a dab, dab, dab. Like, if it’s not absolute it’s OK. You can accomplish it perfect. I capital a sunsetty attach design, so I best white for my base, again ablaze blush and apricot to alloy together. That’s ugly. I’m accomplishing a abhorrent job. This attach brightness is not my favorite. I’m blaming it on the attach brightness and the attach and the camera setup. Merp. I’m aloof gonna do a distinct coat. I’m not gonna do a bifold covering because I aloof appetite it to dry fast and this is the base. The white isn’t alike gonna show. I corrective the two colors assimilate the sponge, again dabbed that on my nail. I had to add added of the ablaze blush to absolutely get an alike blend. And sometimes it was added acceptable afterwards the band to absolutely get the blush on the corners of my nails, alike admitting it was messier. So, I approved to get the colors on by one apple-pie swipe, and that seemed to assignment bigger than the borer technique. And again I went aback and attenuated the colors. Not bad for a first-time sponger. Not bad. This nondominant duke is kinda accomplishing abhorrent things to me. Yeah, my easily are starting to hurt. I can’t accept I did that one upside down. But, hey, it came out attractive the cutest. So, I begin a actual old architecture besom that I haven’t acclimated in a while and salvaged it into an acetone besom to apple-pie about the nails. Warning:

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[conbonindustries]

Adam Frew

I love ceramics. Not so much the decorative kind or the paint-your-own-pottery kind, but the functional, conventional kind. The kind that people use. 

Can’t be certain what it is exactly, but uniformity made by hand (with just enough human touch that you can TELL it’s made by hand) is, to me, the most beautiful craft. I have collections of plates and cups handmade in Japan, stacks of mugs made by this incredible Irish potter – Adam Frew – and an insane number of tiny one-off pieces that I’ve collected for 15 years from craft fairs and boutiques all over the world. It may technically be an addiction, but first I’d have to admit I have a problem, right?

I especially love Adam’s mark-making on his otherwise jade, utilitarian forms. The ultramarines and bright oranges sparkle on the work just enough that I still believe its practicality, without tipping too far into the decorative. (Of course, Adam does make beautiful decorative pots and vases, but I prefer the simple over the flashy.) The abstraction and painterly strokes of contrasting glazes, with mostly hard edges of jade containing many organic, rough, sometimes drippy and wet naturalizations of blue and white, are such a fresh take on a classic combination of Asian coloring.

When I work with young designers in my classes at The Creative Circus, I always tell them that editing OUT is just as important as putting IN. That might be a no-brainer to some, but when I was starting out at Martha, it was so  important for me to study how spaces left white (or empty) influenced the calm, sophisticated vibes on the pages of her magazine versus how much information was crammed into a spread. I tended to cram, if we’re being honest.

There’s a lesson in there somewhere. Like, knowing which parts of the pot to leave jade is just as much of a skill as painting the parts that are blue.

Anyway, Adam’s having a sale and I just bought some small pieces (not exactly small prices...merp) so if you like what you see, you can partake. 

[juniperpublishersnursing]

Verbal Orders in Medicine: Challenges; Problems and Solutions-Juniper Publishers

Abstract

Introduction and objective: Despite the many advantages of a verbal order, some disadvantages have been identified with this method. This study examines the problems encountered through the use of verbal orders and the various solutions offered to reduce the clinical errors caused by such method.

Methods: 83 articles published in English between 2000 and 2016 were extracted from Pubmed, Pro-Quest, Google Scholar, and Science direct databases. After a qualitative review of these articles, 32 of them were selected that were relevant to the objective of this study.

Background: Most of the aspects of verbal orders that have been studied include: the process of providing verbal orders and reason for errors, competency of the individuals who prescribe and receive verbal orders, method of documentation, limitations, authorization & validation, strategies, techniques and specific measures to enhance transparency and effectiveness, considering two characteristics of the content and context.

Results: The most common recommendations for the paper method in order to reduce errors are to restrict the use of this kind of order and/or to repeat the order. Computerized Physician Order Entry (CPOE) & mobile CPOE tools are among the recommended health information technology solutions that not only increase the efficiency of the order process but also support the displacement of verbal prescribers.

Conclusion: The use of mobile-based information systems is on the rise because they are more flexible and allow greater mobility to the users compared to other information systems. Furthermore, mobile-based information systems can collect, store and analyze the detailed information of verbal orders in a more efficient way.

Keywords:  Electronic clinical documentation; Communication; Computerized physician order entry systems

    Introduction

One of the effective communication tools between members of the healthcare team is medical orders forms; it is necessary for the healthcare team members to exchange information while working. This information can be direct (for example, verbal conversations) or indirect (e.g. entering data into health information systems). Verbal order is common as an informal communication tool between doctors and nurses and increases interoperability between them [1].

National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP), defines medication errors of verbal orders as medication orders which are provided face-to-face or, by phone or through other voice communication means [2]. These kind of orders are often used when prescribers, including physicians or physician assistants, are unable or unwilling to write patient care orders [3]. Verbal orders have been common, since earlier times, as a method of communication and are used in different health areas, including hospitals, nursing homes, clinics and hospice. In non-office hours, verbal orders are one of the most common methods of communication [4]. In addition to using other communication technologies such as phone, fax, and email, SMS is also used in 84.1% of verbal orders. It is estimated that, in more than 20%; of cases, medical orders in hospitals are given orally. These verbal orders can be an order or series of orders during an ordering event (for example, ordering a laboratory test, discontinuing one medication, and starting a second medication) and may cover all types of orders (e.g., diagnostic tests, clinical counseling, medications and other therapeutic interventions) [5]. If the orders are received by a competent and authorized person, then the decision will be timely and more reliable and will accelerate the work; and, if they are duly signed, these orders become legal. The important thing is that, basically, these types of orders have error potential. The factors that cause the error in the verbal orders include: fatigue of prescriber or order receiver, similarity of the names of drugs, noise in the environment, accents, dialects, spelling differences, unfamiliarity with conditions and the patient's condition, and unfamiliar terms [6].

A study by Chu et al. [7] indicates that, in 19% of errors in the field of medicine, 2.3% are related to verbal orders [7]. Therefore, this method should be used only in emergency conditions and, where not possible, to write the order, or to enter information into the computer; for example, when a doctor is involved in surgery or treatment and where it is not possible to interrupt him/her [8].

The «The Joint Commission for the Accreditation of Healthcare Organizations» (JCAHO) also confirms that the use of verbal orders certainly cannot be banned, but its use can be minimized [9]. It can be used at certain times; so, although verbal orders are problematic because of audio issues, etc., care centers will continue to use the verbal order method now and in the not too distant future; this is because of the distance between the place where the orders are given and where the information is entered electronically, clinical necessity or prescriber preference and convenience [10]. The use of verbal orders has problems in addition to its advantages and efforts are being made to fix them. The aim of this study was to address the problems, challenges and different solutions offered to reduce the error caused by the verbal order.

    Methods

In line with the objectives of the study, a total of 670 articles in English published from 2000 to 2016 were extracted through a comprehensive and detailed review of the scientifically valid publication databases like Science direct, Pubmed, ProQuest and Google Scholar. At this stage, after re-examining and removing unrelated articles, 83 articles remained. Inclusion criteria for the study were based on their relationship with the aim of the study and subject relation. To investigate the quality of the articles in possession, they were evaluated in terms of title, abstract, introduction, research method, results, discussion and references. After final assessment, 32 selected articles were carefully studied and the content, were developed in a proper sequence to meet the goal of the study.

    Background

As mentioned above, verbal orders have been identified as a risk factor for the patients and, when combined with the pressure of overwork and inexperience of staff, the possibility of error increases.

It is necessary for healthcare institutions to perform actions while using these orders to reduce errors. Some common errors in using verbal orders include: incorrect expression of patient's status, naming similarity of the patients, making the wrong decision, no request for clarification, confusion and/or not read back the verbal order, errors in prescription writing.

Recipients of verbal orders might make mistakes in the audition, understanding and writing of orders, or Misunderstand sound- a like medication. In addition to the names of drugs, mistakes might occur in dosage or drug usage. Several examples of errors in the use of this type orders have been reported [10].

In multilingual environments, there is a possibility of misunderstanding verbal orders [11]; also, due to the use of masks by doctors, the order may be heard wrongly [12]. Thus, in order to minimize errors and injuries related to the issuing of verbal orders, recommendations have been proposed by authorities and various organizations, including the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP).The most commonly recommended method to reduce verbal order error, and to increase the validity and reliability of documentation processes, is the read back method. All orders must be recorded and registered by nurses who receive the order and then should request the doctor to repeat the order. The doctor should also repeat it to him/herself [13]. The recipient of the order should announce more complete information about the patient's history and the medications consumed and the prescriber must sign it within the following 48 hours [6,14-16].Sometimes in the healthcare system this is not done for the following reasons [6]:

Misunderstanding of medications with similar names.

Fear of incompetence in the view of the other person.

Possible negative response of the prescriber.

Inadequate number of employees relative to the workload.

Previous experience between prescriber and order receiver in working together.

According to a study conducted by Rask et al. [17], although most hospitals had a read back policy for verbal order, only 36% of them have policies and procedures to reduce verbal orders [17].

Restrictions are also applied to prohibit the use of verbal orders in order to prescribe high-alert drugs such as Thrombolytic or Heparin [9].

The policy of not accepting verbal chemotherapy orders is becoming common in the field of healthcare. Most available studies have investigated the following items in verbal orders:

The times of use or non-use of verbal orders [18].

The persons authorized to prescribe and receive verbal orders.

The process of providing verbal orders and the reasons for their error.

The essential items in the registration of contents of verbal orders.

Limitations and restrictions on the use of verbal orders.

How is the authorization and validation of the verbal orders defined?

What are the strategies, techniques and specific measures to enhance the transparency and effectiveness of verbal orders? [19]

Requirements for the periodic monitoring and evaluation of verbal orders and their compliance with organizational policies and procedures [6,15,20].

Attending two features of the content and context in verbal orders that can be the cause of the error.

Recommendations that have commonly been given in the use of verbal orders in healthcare include:

A. Oral communication should only be used in emergency situations [21,22], where it is not possible to write or input information into the computer [6], (e.g. when the prescriber is in a sterile environment) [14].

B. Policies and procedures in health centers to restrict and prohibit the use of verbal orders[19].

C. Providing a process to ensure the legality of the physician in providing verbal orders.

D. Explaining the situation in which verbal orders were used.

E. Determination of authorized recipients and prescribers of verbal orders.

F. Providing guidelines for clear and effective communication in verbal orders.

a. For example, the prescriber and the recipient of the prescription can spell out the names of unfamiliar drugs letter by letter [14,23].

G. Immediate registration and signing of verbal orders by the person receiving the order.

H. Reviewing and signing the verbal orders recorded in the medical records of patients as soon as possible.

I. Identification of components that must be included in verbal orders [15,23].

J. Review and verification of verbal orders when the recipient of the order does not have enough experience [22].

Two characteristics of verbal orders that can be the cause of errors include the content and context of the verbal orders. The content of verbal orders refers to the number and type of each instruction given orally. The text of the verbal orders relates to the general condition or situation that the verbal orders are made under, the conversation process and confirmation and rewriting the orders. The content of verbal orders regarding hospitalized patients has many complications that may cause the error. Examples of content variables in verbal orders include: the number of orders, different types of orders (for example, pharmacy, laboratory, radiology), the complexity of orders, urgency of orders, non-standard abbreviations and terminology, the use of drugs with similar names, dosages of high-alert drugs.

Environmental variables regarding verbal orders are as follows: type of place providing healthcare, timing communication processes, multiple methods of communication, noise levels in the environment, the characteristics of employees, level of familiarity of the providers and recipients of verbal orders with the patient, differences in intelligence of providers and recipients of orders, differences in language skills and clarity of communications of each of the speakers of verbal orders [10].

To find a solution to reduce the harms of verbal orders before the intervention, a greater understanding of the complexity of these orders, and how this complexity may lead to an increase in injury or mistake, and to identify the effective tools, are required to ensure proper verbal orders, and to use them correctly [2].

One of the factors that could be the cause of problems is a delay in signing the documentation on the part of the physician [24]. In order to solve this problem, the training of medical assistants to get them to complete documentation has been emphasized. Also, in some cases, nurses are not aware of the rules and guidelines of verbal orders; in this regard, training and awareness among the nurses is emphasized [25].

Besides the different methods proposed to achieve the patient's safety in manual systems, the use of information technology is considered as an appropriate approach to provide safe care and to reduce the risks involved in healthcare. According to the National Quality Forum (NQF), one effective way to improve patient safety, and which should be prioritized in this research, is the use of computerized physician order entry (CPOE) instead of verbal orders.

Brunt et al. [26] study shows that, after the implementation of Tele CPOE, the number of verbal orders has decreased. Non-compliance and lack of complete documentation are the problems encountered in the use of this system. Yeon Kim et al. [27] study proves that, by using CPOE, the completed documentation for laboratory orders demanded verbally has reached 100%; and this computerized process has been accepted by healthcare providers [27]. Implementing this system at the Children's Hospital in Pittsburgh as a compliance of verbal orders has increased from 80% to 95% [28].

An example of the difficulties experienced in verbal order data entry after implementing CPOE is as follows: A nurse, when selecting the physician's name from the list of doctors, chooses a physician's name by mistake and the doctors were faced with orders that were associated with his name. However, they did not implement healthcare measures for the patient. To solve this problem, the nurses were trained in the importance of choosing the right name of the doctor and, therefore, its importance was noted. In addition, it was redesigned so that, when choosing the name, a new page is displayed and the nurse is asked again about the accuracy of physician’s name [29].

Electronic systems have been implemented to stop the use of verbal orders. However, in certain circumstances, when using CPOE, it is observed that healthcare providers are forced to bypass it and verbal orders are often still used [30].

Note that one of the reasons for using verbal orders is the mobility of care providers, because patients and health sectors are not accessible in one place and at the same time. On the other hand, mobile phones are now advanced communication devices that have high processing powers and provide a quick and easy connection; they also enable access to data wherever possible, quickly and easily.

In order to increase efficiency and mobility, Wookjin Choi et al. [31] have designed a mobile-based Electronic Health Records (EHR) application. One of the components of this software is verbal order exchange [31]. Zarka et al. [19] have designed a mobile-based computerized physician order entry application called Patient Keeper, which provides access to patient medical data. One of its objectives is to reduce verbal orders.

In using electronic documentation tools, including CPOE or EHR, it is important to note that, if these means are more up-to- date and make it possible to store the verbally exchanges data, then they will increase the effectiveness of communication [32].

In 2009, Mendel and Kohan found that the clinical implications are due to the inflexible design of EHR. The possibility of integrating and quick access to data on the organization's information systems is provided by mobile developers who are inspired by the agile methods and design high quality, applied mobile applications [

33

].

    Results

As mentioned above, verbal order is considered an important communication mechanism in healthcare systems but which, for various reasons, can lead to errors and impact patient safety and quality of healthcare. Since it is not possible to eliminate this method of communication, solutions have been provided to reduce errors in the use of this method. The findings from the study show that the proposed solutions to mitigate existing problems can be divided into two groups: paper-based and electronic.

In the standards and clinical guidelines on the use of verbal orders, it is emphasized that healthcare provider organizations should apply policies and procedures to limit verbal orders and to use the read back method. This will increase the clarity and accuracy of this type of order, where the verbal order process is clearly described and a process is expressed to ensure the people who are entitled to receive the orders and components and documentation method are properly advised. This method should also be utilized by care providers, including doctors and nurses, who should have adequate knowledge about the instructions and follow them. Also, in residency training, appropriate education to complete and sign documents in a timely fashion could form their appropriate professional behavior so that doctors are obliged to observe these items.

According to the increased use of computerized systems by healthcare provider organizations, solutions have been provided to reduce the use of verbal orders in this way. Many studies have introduced Tele CPOE and mobile-based CPOE as solutions to increase the efficiency and to support the shift of verbal order prescribers.

Numerous studies have examined the impact of computer systems on verbal orders. The results indicate that, by implementing the computer systems, the following issues have declined:

The number of verbal orders [18,34,35].

The interval between verbal orders of doctors to its signing.

The number of unsigned orders.

Incompatibility of verbal orders [36].

Although, in many studies, the positive impact of computerized systems on verbal orders has been studied, in certain circumstances, healthcare providers are forced to bypass it. Also, the use of this type of order is common in clinical environments.

    Conclusion and Suggestion

The results of this study indicate that the use of verbal orders, in spite of its advantages, is considered as the cause of errors in the process of providing healthcare. Therefore, reviewing and updating policies in the healthcare centers is essential to ensure the proper implementation of orders and optimizing patient safety and reducing healthcare concerns.

One reason for the use of verbal orders is the absence of the physician in the healthcare organization, especially in non-working hours, thus causing a lack of access and lack of attention to the patient care data. Therefore, information technology, especially CPOE, can reduce the amount of verbal orders and the errors. Moreover, with the rapid growth of mobile-based information systems, the ability to design and develop information systems is much more flexible compared to traditional information systems. Mobile-based information systems will give users more mobility and the use of these systems will provide the ability to collect; analyze and store detailed information of verbal orders, in a more updated and effective form. For the convenience of mobile the fore mentioned problem will be solved through applying CPOE by doctors.

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[usstreesparrow]

REALLY GREAT QUESTION. THANK YOU.

ABSTRACT; Surgical and medical play; shibari; HUGE into pet play

CLOVER: also into petplay; knifeplay/weapon kink; religion/blasphemy; bondage

BEATRICE: well she is objectum except for quin. mostly vanilla tbh

T'VIA: femdom. bondage. she is the kinkiest of them all. she is crazy

LEKLO: impact play, pegging, branding, etc

QUIN: office/public sex, breathplay/control, breeding

XORIENNE: food; monsterfucking; voyeurism; consensual nonconsent; wax/temperature play

KALVRINNA: extremely sexually compatible. also monsterfucking. both have a huge thing for hypnosis/intox

[bearcatart]

abstract merp and her controversially younger girlfriend

i always forget clover's tail

[usstreesparrow]

I don't wanna wake you (Though I May Have To) | Abstract Merp/Clover V'Lyty

RATING: EXPLICIT!!

The tendrils on Abstract’s face writhe and brush against Clover’s whiskers as they kiss, as Clover slips small gasp-purrs into Abstract’s blue lips, as the ship freezes in stasis around their locked bodies, immobilized in the time stream, merged in the moment. Clover has wanted this for—

  “Um, hi—ah, greetings?---Captain…Abstract? I’m Ensign Clover V’Lyty. My specialty is, um, xenoveterinary. I’ll be looking after any injured or sick animals we may come across.”

  The Captain actually trips over her own feet - fucking somehow - as she stumbles miles and miles through her office in a very valiant attempt to greet Clover. When she finally reaches her destination—her hand warm in Clover’s, their both palms damp with sweat—she gives an awkward smile, and nods.

  “Greetings, Ensign,” says Abstract Merp. She inhales, as if preparing to drone out a long speech, but what comes out is more impassioned and raw than any memory Clover can conjure in the moment: “Long ago, the first spacewalkers of my kind were pleased when they finally managed to develop the technology that would allow them to exit the atmosphere and view our planet from above. They looked down upon the planet and shook in awe of its beauty, elegance, and potential. Just as they were excited to have sparked a new age of space exploration, I am excited to greet every member of my crew. Inside of me, as we prepare to leave the station and embark on our mission to the comforts of the wilderness and all that dwells within it, I feel only a universe-expanding warmth, and I cannot wait.”

  Clover laughs. “Wow, is that what you tell all the girls?”

  But Abstract only frowns. “I… apologize. I give a variant of this speech to each fresh crewmember. The woman who will be our first officer, Commander T’Via, translates for me on an eternal basis; however, for a reason that seems to have escaped the void of me, she has not returned from her meeting with the Admiral eight hours before this second.”

  This is when Clover r e a l i z e s: oh, she Just Talks Like That.

  Clover has wanted this for—-------------------

  a very long time. An omnipresent wantingthing, a creature that has transformed beyond recognition because of its desire, a real horror movie monster directed from her own hands, her own puppeted strings, her own fingers inside the teal of Abstract’s hair. A captain and her most trusted, most beloved ensign, following behind her and floating above her and holding her close. It’s odd to think that they’ve been out here for a year now. It’s odd to think that most people would consider this immoral. 

  Abstract’s hands curl under Clover’s uniform, but she pushes Clover away too fast for either of them to process, her hand entwining with Clover’s just as their hands had when they shook for the first time all those months, years, centuries ago, in the Before, in the Pre-Universe of their universe. She gives a solemn smile. “You know that we are unable to speak freely of this entanglement of ours… I will help you if you desire aid in controlling the fury that stirs within you; I know that it boils you up, scorching you from the inside just underneath the surface, and I do not judge… but we cannot have a repeat of such an incident as your actions the other day. This must remain a secret.”

  Clover scoffs. “I know—” she stops herself before she can launch into anger—-breathe in, breathe out, as Dr. Diaz had said, hold for six seconds, exhale for six seconds, breathe in for six seconds, hold—close your eyes and imagine a calmer world— “I know,” she continues. “I’m sorry. I just lost my temper when he said that to you. I played it off as just being really defensive of my captain, but I mean—come on, Abstract, you know he thinks—”

  “Yes,” Abstract interrupts. “I am aware of his opinion on me. I am aware that he sees my eccentricities and my manner of speech and views me as a disjointed exhibit. As he put it: A “joke”. But I am accustomed to this treatment. You must be, too.” She kisses Clover’s forehead. “You must not disrespect a Starfleet admiral. It will not win us any favors.”

  “It’s not fair!” Clover cries, her fists pounding into her thighs. “I don’t think people should be allowed to treat you that way.”

  “Perhaps, but it is the hand that I have been dealt in the intricacies of life’s game, and I must play it as the rules instruct.”

  Clover squeezes Abstract’s hand. “I wish we didn’t have to lie about this.”

  Another kiss, more heat, and the simmer of Clover’s anger burns out beneath Abstract’s touch, taming her into a domesticated beast, something walking on four legs, heeling for its owner, loved as a companion, a delegated family member.““As do I,” says Abstract. “ Trust me.”

  And oh! How Abstract wants to sing, to scratch Clover behind her feline ears and kiss her in all of the holy, hallowed places, to ride up her uniform and feel Clover ride her and touch the innards of her soulguts and get her there, to worship her beautiful young muse, painted and performed and honored. But she cannot.

[usstreesparrow]

Stray [Clover & Abstract Merp]

stray (121 words) Rating: Teen And Up Audiences

For the 3 sentence ficathon on Dreamwidth.

She feels Clover purr against her chest, the vibration like a thunderstorm after devastating drought—she is, at times, one of the only aspects of this mission that can make isolation in deep space bearable. Abstract is the captain; she loves her job, loves the stars and the universe and all of the little creatures swirling around in it; she cannot struggle with the mission. She has people to protect and guide and lead—Clover is supposed to be one of them, her chosen and most talented ensign, her lead xenoveterinarian—but they both exist as real flesh beings outside of their careers—they both deserve to have their ears scratched and their bellies rubbed and their hearts taken care of.