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ISSN 1656-8788

Recruitment and Performance Appraisal of Human Resources
Two of the essential human resource management functions are recruitment and performance appraisal of workforce needed in the organization.

Adverse Drug Reactions

Dr. Raul Salvador

An adverse drug reaction (abbreviated ADR) is a term to describe the unwanted, negative consequences sometimes associated with the use of different medications. ADR is a particular type of adverse effect. The term is preferred over the colloquial and imprecise "side effect", as the term "side effect" implies the potential for beneficial consequences, and that the effects are not explained by the pharmacological actions of the drug. They can occur for many reasons, including the following: (a) the drug may have other effects on the body besides the therapeutic effect; (b) the patient is sensitive to the drug being given; (c) the drug's action on the body causes other responses that are undesirable or unpleasant; (d) the patient is taking too much or too little of the drug, leading to adverse effects. The type of adverse of drug reaction can be any of the following: Primary actions. One of the most common occurrences in drug therapy is the development of adverse effects from simple over dosage. Secondary actions. Undesired effects. Example antihistaminic side effects is drowsiness and drying up of secretions.

Hypersensitivity. Over-reactions from both primary and secondary reactions. This term is sometimes interchangeably used with the term drug allergy. The nurse, who frequently administers medications, must be constantly alert for signs of drug reactions of various types. Patients and their families need to be taught what to look for when patients are taking drugs at home. Some adverse effects can be countered with specific comfort measures or precautions. Knowing that these effects may occur and what actions can be taken to prevent or cope with them, may be the most critical factor in helping the patient to comply with drug therapy. Drug Allergy Drug Allergy occurs when the body forms antibodies to a particular drug, causing an immune response when the person is reexposed to the drug. A patient cannot be allergic to a drug that has never been taken, although patients can have cross-allergies to drugs within the same drug class as one formerly taken. Here are four main classifications of drug allergies, namely: (1) anaphylactic reactions;

(2) cytotoxic reactions; (3) serum sickness; and (4) delayed reactions. Drug-Induced Tissue and Organ Damage Dermatological reactions are adverse reactions involving the skin. These can range from a simple rash to potentially fatal exfoliative dermatitis. Interventions In mild cases of skin lesion: provide frequent skin care; instruct the patient to avoid rubbing, tight or rough clothing, and harsh soaps or perfumed lotions; administer antihistamines, as appropriate. In severe cases, discontinue the drug and notify the prescriber. Be aware that, topical corticosteroids/antihistamines, and emollients are frequently used.

Interventions Provide frequent mouth care with a non irritating solution. Offer nutrition evaluation and development of a tolerated diet, which usually involves frequent, small meals. Arrange for a dental consultation. Note that antifungal agents and/or local anesthetics are sometimes used. Super-Infections One of the body's protective mechanisms is the wide variety of bacteria that live within or on the surface of the body. This bacterial growth is called the normal flora. The normal flora protects the body from invasion by other bacteria, viruses, fungi, and so on. Several kinds of drugs (especially antibiotics) destroy the normal flora, leading to the development of superinfections or infections caused by the usually controlled organisms. Symptoms can include fever, diarrhea, black or hairy tongue, inflamed and swollen tongue (glossitis), mucous membrane lesions, and vaginal discharge with or without itching. Interventions Provide supportive measures (frequent mouth care, skin care, and access to bathroom facilities, small and frequent meals). Administer antifungal therapy as appropriate. In severe cases, discontinue the drug responsible for the super infection. Blood Dyscrasia Blood dyscrasia is bone marrow suppression caused by drug effects. This occurs when drugs that can cause cell death (e.g., antineoplastics, antibiotics) are used. Bone marrow cells multiply rapidly; they are said to be rapidly turning over. Because they go through cell division and multiply so

A closer look at the skin

GIT Stomatitis, or inflammation of the mucous membranes, can occur because of a direct toxic reaction to the drug or because the drug deposits in the end capillaries in the mucous membranes, leading to inflammation. Symptoms can include swollen gums, inflamed gums (gingivitis), swollen and red tongue (glossitis), difficulty swallowing, bad breath, and pain in the mouth and throat.

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often, they are highly susceptible to any agent that disrupts cell function Symptoms include fever, chills, sore throat, weakness, back pain, dark urine, decreased hematocrit (anemia), low platelet count (thrombocytopenia), low white blood cell count (leukopenia), and a reduction of all cellular elements of the complete blood count (pancytopenia). Interventions Monitor blood counts. Provide supportive measures (rest, protection from exposure to infections, protection from injury, avoidance of activities that might result in injury or bleeding). In severe cases, discontinue the drug or stop administration until the bone marrow recovers to a safe level Liver Injury Oral drugs are absorbed and passed directly into the liver in the first-pass effect. This exposes the liver cells to the full impact of the drug before it is broken down for circulation throughout the body. Most drugs are metabolized in the liver, so any metabolites that are irritating or toxic will also affect liver integrity. Symptoms may include fever, malaise, nausea, vomiting, jaundice, change in color of urine or stools, abdominal pain or colic, elevated liver enzymes (e.g., aspartate aminotransferase [AST], alanine aminotransferase [ALT]), alterations in bilirubin levels, and changes in clotting factors (e.g., partial thromboplastin time). Interventions Discontinue the drug and notify the prescriber. Offer supportive measures (small, frequent meals; skin care; cool environment; rest periods. Renal Injury The glomerulus in the kidney has a very small capillary network that filters the
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blood into the renal tubule. Some drug molecules are just the right size to get plugged into the capillary network, causing acute inflammation and severe renal problems. Some drugs are excreted from the kidney unchanged: they have the potential to directly irritate the renal tubule and alter normal absorption and secretion processes. Gentamicin (Garamvcin), a potent antibiotic, is frequently associated with renal toxicity. Symptoms would include elevated blood urea nitrogen (BUN), elevated creatinine concentration, decreased hematocrit, electrolyte imbalances, fatigue, malaise, edema, irritability, and skin rash. Interventions Notify the prescriber and/or primary caregiver and discontinue the drug as needed. Offer supportive measures (eg, positioning, diet and fluid restrictions, skin care, electrolyte therapy, rest periods, controlled environment). In severe cases, be aware that dialysis may be required for survival. Poisoning Poisoning occurs when an overdose of a drug damages multiple body systems, leading to the potential for fatal reactions. Assessment parameters vary with the particular drug. Treatment of drug poisoning also varies, depending on the drug. Antidotes are specifics for each type of poison. Emergency and life support measures often are needed in severe cases. Alterations in Glucose Metabolism a. Hypoglycemia Hypoglycemia is antidiabetic agents which have the desired action of lowering the blood glucose level, but which can lower blood glucose too far, causing hypoglycemia. Symptoms may include fatigue; drowsiness: hunger: anxiety; headache; cold, clammy skin; shaking and lack of coordination; increased heart rate: increased blood

pressure; numbness and tingling of the mouth, tongue, and/or lips; confusion; and rapid and shallow respirations. In severe cases, seizures and/or coma may occur. Interventions Restore glucose, intravenously (IV) or orally if possible. Provide supportive measures (eg, skin care, environmental control of light and temperature, rest). Institute safety measures to prevent injury or falls. Offer reassurance to help the patient cope with the experience. b. Hyperglycemia Some drugs stimulate the breakdown of glycogen or alter metabolism in such a way as to cause high scrum glucose levels, or hyperglycemia, ephedrine (generic), a drug used as a bronchodilator and anti asthma drug and to relieve nasal congestion, can break down stored glycogen and cause an elevation of blood glucose by its effects on the sympathetic nervous system. Symptoms include fatigue, increased urination (polyuria), increased thirst (polydipsia). deep respirations (Kussmaul's respirations), restlessness, increased hunger (polyphagia), nausea, hot or flushed skin, and fruity odor to breathe may be observed. Interventions Administer insulin therapy to decrease blood glucose as appropriate. Provide support to help the patient deal with signs and symptoms (eg, access to bathroom facilities, controlled environment, reassurance, mouth care). Electrolyte Imbalances a. Hypokalemia Some drugs affecting the kidney can cause low serum potassium levels (hypokalemia) by altering the renal exchange system. For example, loop diuretics function by causing the loss of potassium as well as sodium and water. Potassium is essential for the normal
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functioning of nerves and muscles. Symptoms include a serum potassium concentration ([K]) lower than 3.5 mEq/L, weakness, and numbness and tingling in the extremities, muscle cramps, nausea, vomiting, diarrhea, decreased bowel sounds, irregular pulse, weak pulse, orthostatic hypotension, and disorientation. In severe cases, paralytic ileus (absent bowel sounds, abdominal distention, and acute abdomen) may occur). b. Hyperkalemia Potassium-sparing diuretics, can lead to potassium retention and a resultant increase in serum potassium levels (hyperkalemia). Other drugs that cause cell death or injury, such as many an-tineoplastic agents, also can cause the cells to release potassium, leading to hyperkalemia. Symptoms include a serum potassium level higher than 5.0 mEq/L, weakness, muscle cramps, diarrhea, numbness and tingling, slow heart rate, low blood pressure, decreased urine output, and difficulty breathing Conclusion In principle, medical professionals are required to report all adverse effects related to a specific form of therapy. In practice, it is at the discretion of the professional to determine whether a medical event is at all related to the therapy. Reference
Karch, M. ( 2003). Focus on Nursing Pharmacology.Lippincott Williams & Wilkins.

Dr. Raul S. Salvador Full time Faculty School of Nursing Research Interests: Pharmacology, Psychiatric Nursing, Mental Health Contact Number 736-02-356 loc. 72

Recruitment and Performance Appraisal of Human Resources

Mrs. Mercedes Versoza

to a post office box number or to an employment firm acting as an agent between applicant and the organization. Although blind ads can assist HRM in finding qualified applicants. Many individuals maybe reluctant to answer them. There is the fear sometimes justified that the advertisement has been placed by the organization in which the individual is currently employed. Recruitment approaches. The external sources include advertisements (including internet postings) employment agencies, schools, colleges and universities, professional organizations and unsolicited applicants. This can be done through external recruitment and internal recruitment. Internal sources are employees who hold other positions in the organization. Organization recruit existing employees through job postings, or communicating information about vacancy on company bulletin boards in employee publications, on corporate internets and anywhere else the organization communicates with employees. Managers may also identify candidate to recommend for vacancies. Many large organizations attempt to develop their own low-level employees for higher positions. These promotions can occur through an internal search of current employers who have bid for the job, been identified through the organizations HR Department, it have been referred by a fellow employee. The internal source or promotion from within policy, wherever possible has the following advantages: It builds morale It encourages good individuals who are ambitious.

Two of the essential human resource management functions are recruitment and performance appraisal of the workforce needed in the organization. 1. Recruitment It is the process of attracting the best qualified individuals to apply for a given job based on the job description and job specification previously done for this job. The typical recruitment goes through the process of the: advertisement of a position vacancy; preliminary contact with potential job candidates; and preliminary screening to obtain a pool of candidates. Advertisement when an organization whishes to tell the public it has a vacancy, advertisements is one of the most popular method used. It can be read in a daily newspaper, in a billboard that the organization is now hiring or in some bulletin boards or newspaper publications. Some organizations place a blind-box ad, one that includes no specific identification of the organization. Applicants are asked to reply

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It improves the probability of a good selection, because information on the individuals performance is readily available It is less costly than going outside to recruit The use of internal sources may also have a distinct disadvantage. A less qualified internal sources maybe hired by the organization when excellent candidates are available on the outside. Internal searches may also generate infighting among rival candidates for promotion and decrease morale levels of those not selected. Selection is a series of steps from initial applicant screening to final hiring of the new employee and it involves these steps:
Completing Application Materials It is the process of gathering applicants background and experiences. The typical application materials would include: a) traditional application forms, b) resumes, c)sometimes tests may be included with application materials

2. Performance Appraisal It is a process of systemically evaluating performance and providing feedback upon which performance adjustments can be made. Performance appraisal should be based on job analysis, job description, and job specifications. Functions a. defines the specific job criteria against which performance will be measured b. measures past performance accurately c. justifies rewards thereby differentiating between high and low performance d. defines rates needed development experiences Purposes The four functions describe two general purposes of good performance appraisal. 1. Evaluation. Concerned with issues regarding promotions, transfers, terminations and salary increases. When theses issues are decided on the basis of performance, a performance appraisal system is needed. 2. Feedback and Development. Letting ratees know where they stand in terms of expectations and performance objectives. Feedback should involve a detailed discussion of the ratees strength and weaknesses. Feedback can be used as a basis for coaching and training by manager. The following people conduct performance appraisal. Ratees immediate superior Ratees peers Ratees subordinates Self-assessment Customers the

Conducting An Interview Typically used though they are subject to perceptual distortions. Interviews can provide a rough idea concerning the persons fit with the job and the organization. Completing Any Necessary Tests Adminstered before or after the interview. Common examples of employment tests are cognitive, clerical and mechanical aptitudes or abilities, personality, drug use, performance, assessment centers

Completing Any Necessary Tests Adminstered before or after the interview. Common examples of employment tests are cognitive, clerical and mechanical aptitudes or abilities, personality, drug use, performance, assessment centers

Doing Background Investigation Can be used early or late in selection process. Background investigations include: basic level checks and reference checks. Deciding To Hire And Not To Hire Draws on information produced in preceding selection steps. A job offer is made. A physical examination maybe required if it is relevant to job performance. Negotiation of salary and/or benefits for some jobs. Orienting New Employees To: firm work units in which they will be working firms policies and procedures firms organizational structure

the the the the

Performance Appraisal Methods There are many types of performance appraisal method. The first group is the Comparative method which seeks to identify a persons relative standing among those

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people being rated. This include ranking; paired comparison; and forced distribution. 1. Ranking - Consists of rank ordering individuals from best to worst on each performance dimension. - Relatively simple to use - Can be burdensome when evaluating a large number of people 2. Paired Comparison - Each person is directly compared with every other person being rated - Final performance ranking reflects the frequency of endorsement across all pairs - Can be very tedious when many people must be compared 3. Forced Distribution - Uses a small number of performance categories and rater assigns a specific proportion of employees to each category - Forces rater to use all categories - Can be problematic if most of the employees perform similarly The second group involves the Absolute methods which specify precise measurement standards. These include graphic rating skills; critical incident diary; behaviorally anchored rating scales; and management by objectives. 1. Graphic Rating Scales o Contain a list of dimensions related to high performance, and the rater assigns an individual score on each dimension. o Easy and efficient to use. o Conundrum of job relevance and generality across jobs. 2. Critical Incident Diary o Record of incidents of each subordinates behavior that led to unusual success or failure in a given performance aspect. o Excellent for development and feedback due to qualitative emphasis. o Difficult to use for evaluation due to lack of quantitative emphasis.
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Behaviorally anchored rating scales (BARS) o Developed through the careful collection of observable job behaviors that describe both superior and inferior performance. o A rating scale is developed that anchors specific critical behaviors, each of which reflects a different degree of performance effectiveness. o Provides specific behaviors that are useful for counseling and feedback. o May not be as superior as once thought. o The Behavioral Observation Scale (BOS) is a simpler variation of BARS.

4. Management by Objectives (MBO) o Subordinates work with their supervisor to establish specific taskrelated objectives. It is the most individualized appraisal method. Works well with counseling, provided the goals focus on important activities. It is not highly subjective to rating errors.

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To be meaningful, an appraisal system must be reliable to provide consistent results across time and valid to actually measure people on relevant job content. Measurement Errors Measurement errors can threaten the reliability or validity of performance appraisals. These errors are as follows: Halo the raters evaluate the ratee on several different dimensions and give a similar rating for each dimension. Leniency raters tend to everyone relatively high ratings. Strictness raters tend to everyone relatively low ratings. give


Central tendency raters lump everyone together around the average or middle. Low Differentiation raters restrict themselves to a small part of the rating scales. Examples include leniency, strictness, and central tendency errors. Recency - raters allow recent events to exercise undue influence on their ratings. Personal bias raters let personal biases, such as stereotypes, to unduly influence the ratings.

Managing human resources effectively has become vital to organizations of the twenty-first century. The heightened levels of global competitiveness have alerted all firms to the fact that all their resources must be utilized well than ever before. Human resource management has received much attention recently because of the recognition that much more could be gained from a better handling of the field. Consequently academics have begun to devote more attention to the topic. References
Schuler, R.S.(1995) Managing Human Resources5th edn, St Paul, MN: West Publishing Co. Lawrence, P.R. and Lorsch, J.W.(1967) Organization and Environment. Boston, MA: Harvard University Press.
Mrs. Mercedes Versoza
Faculty School of Business and Accountancy Research Interests: Finance, Human Resource Mgt. Contact Number 736-02-35 local 162

However, the rating errors can be reduced and performance appraisals improved by doing these strategies: Train raters to understand the evaluation process and recognize errors. Ensure that raters observe ratees on an ongoing basis. Limit the number of ratees the rater has to evaluate. Ensure the clarity and adequacy of performance dimensions and standards. Avoid terms that have different meanings for different rater.

Lastly, it is necessary to ensure the legality of performance appraisal systems by observing these guidelines: Base appraisal on job requirements as reflected in performance standards. Ensure that employees clearly understand the performance standards. Use clearly defined dimensions. Use behaviorally-based dimensions supported by observable evidence. Avoid abstract trait names. Ensure that scale anchors are brief and logically consistent. Ensure that the system is valid and psychometrically sound. Provide an appeal mechanism to handle appraisal disagreements.

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