NURS 8210 Discussion The promotion of safety and quality in patient care

The promotion of safety and quality in patient care is important in healthcare institutions. Nurses and other healthcare providers achieve safety and quality in patient care by utilizing best practices and evidence-based interventions in addressing their care needs. They also utilize interventions such as inter-professional collaboration to ensure the optimization of the care outcomes of their patients. Institutional factors such as culture are important in driving the desired safety and quality outcomes in patient care. The creation and strengthening of culture of patient safety ensures that the organizational stakeholders such as healthcare providers understand the importance of interventions that contribute to continuous quality improvement in patient care (Lin et al., 2018). Therefore, this presentation focuses on an innovation that intend to address the issue of medication errors.

Christian values are essential to embody in all aspects of life. While GCU utilizes these values as a foundational component for educational standards, these should also be standard for how students are influenced in their academic performance as well. Academic dishonesty, which is the opposite of academic integrity, plagues all academic levels. There are several reasons why I think students are tempted into dishonesty including pressure for success, lack of understanding about what constitutes plagiarism, and not fully understanding the entire process of academia. Integrity is the intrinsic belief to do the right thing even when no one is watching and is an essential value of the Christian doctrine. When students believe and practice integrity, they will be able to apply this outside of the classroom and to other aspects of life. If students are engaging in academic dishonesty, this may be suggestive of a lack of integrity outside of the classroom as well. Lack of integrity is one example of the brokenness seen in society today. It shows a desire for success regardless of the means to get there or if there was any actual self-growth in the achievement of success. Having an educational infrastructure based on Christian values will not only foster academic success but will support students to apply these values beyond the classroom and become a part of their daily lives.

The identified problem from my experience is medication errors. The institution I worked previously had the problem of increasing rates of medication errors. The rise in the rates of medication errors implied that patients were highly predisposed to unintended harm in the institution. The harms were largely attributed to the side effects of the medications and drug interactions with other medications. An analysis of the factors contributing to the errors showed that they could be classified into institutional, provider, and patient factors. Some of the patient factors included sudden changes in health and wellbeing and complex care needed. Examples of provider factors included burnout and lack of knowledge and skills in safe medication practices. The institutional factors included staff shortage and lack of support for initiatives addressing the issue of medication errors. The issue of medication errors is critical in nursing because nurses contribute to the majority of medication errors in healthcare. Nurses handle most of the medication processes such as administration (Mulac et al., 2021). Therefore, it is important to address the issue for patient health and wellbeing as well as organizational performance.

Addressing the problem of medication errors is of great importance to the organization, patients, and healthcare providers. Firstly, addressing the problem enhances the safety of nursing care. It prevents unintended harm to patients due to unsafe practices related to the use of medications. It also assures patients their provision of high quality care with minimal harm. The prevention and reduction of harm due to medication errors therefore translates into quality nursing care. The other importance of addressing the issue is to reduce the healthcare costs. Medication errors predispose patients to harm, which prolongs their hospital stay as well as need for complex or specialized care. As a result, the costs incurred in the care process rises significantly. Addressing the issue of medication errors would therefore result in the reduction in healthcare costs that patients and healthcare institutions incur. The other importance of addressing the issue is that it strengthens the culture of patient safety in the organization. It increases the need for the adoption of interventions that minimize the exposure of patients to safety events. It also increases the need for innovation and continuous quality improvement in systems and processes, hence, the creation of culture of patient safety in the organization (Strudwick et al., 2018).

Post your responses to the Discussion based on the course requirements.

Your Discussion postings should be written in standard edited English and follow APA guidelines as closely as possible given the constraints of the online platform. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Initial postings must be 250–350 words (not including references).

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Week 7 Discussion Rubric

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Week 7 Discussion

Discussion – Week 7

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Decision Support and Innovative Informatics Tools

“Never before in history has innovation offered promise of so much to so many in so short a time.” – Bill Gates (as cited in Frazer, 2007)

Technological innovations are dramatically changing how the health care industry operates. One example of this change is the

transformation of gaming systems and virtual worlds into effective health care devices. Today’s gaming systems are capable of strengthening motor skills during rehabilitation, while virtual worlds promote a form of nonjudgmental communication and self-confidence for those patients who suffer from physical and mental limitations. Innovations such as these have been well received as they promote health in a positive and entertaining way.

In this week’s Discussion, you appraise how these innovations can enhance health care practices. Focus on analyzing innovations with which you may be unfamiliar. For example, you may choose to look at the fields of decision support, robotics, telehealth, and nanotechnologies.

References:

Olsen, S. (2008, May 29). Wii-habilitation, health games get $2 million study grant. CNET News.
Retrieved from http://news.cnet.com/8301-10784_3-9955083-7.html

Tanner, L. (2008, February 9). Hospital using Wii in combat injury rehab. Navy Times.
Retrieved from http://www.navytimes.com/news/2008/02/ap_wiihabilitation_080209/

Mollman, S. (2007, July 27). Wii + Second Life = New training simulator. Wired.
Retrieved from http://www.wired.com/gadgets/miscellaneous/news/2007/07/wiimote

Frazer, G. (2007, December 6). How to nurture innovation in your business. Computer Weekly.
Retrieved from http://www.computerweekly.com/Articles/2007/12/06/228478/How-to-nurture-innovation-in-your-business.htm

To prepare:

Review the information and websites listed in the Learning Resources focusing on decision support and technological innovations in the health care field.
Using credible resources, investigate decisions support systems or other innovations that are in their in today’s health care market.
Select a specific technological innovation to share with your classmates.
Develop a description of your selected decision support system or technology innovation as if you were making a presentation to an interdisciplinary team at your practice.
Include the potential benefits and challenges that this new system could bring to health care practices and the effect it could have on outcomes.

By Day 3 post a cohesive response that addresses the following:

Describe your selected technology, including when it was first introduced into the health care industry.

Assess the applications of the technology, noting the benefits and potential challenges of the innovation.

Appraise the potential of the innovation to improve health care practice and related outcomes.
Read a selection of your colleagues’ postings

Read a selection of your colleagues’ postings.

By Day 6 respond to at least two of your colleagues in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues. NURS 8210 Discussion The promotion of safety and quality in patient care

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Click on the Reply button below to post your response.

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The first wearable devices can be traced back to the late 50s, when an implantable pacemaker was developed for arrhythmia patients (Guk et al, 209). Over the last 6 decades, wearable devices have evolved from being implanted into our bodies to devices we can simply wear on our hands. Wearable devices include wristbands, smartwatches, wearable mobile sensors, and other mobile hub medical devices that collect a large range of data from blood sugar and exercise routines to sleep and mood. Patient data are collected either through consumer reporting or passively through sensors in apps that communicate with devices through application programming interfaces (APIs); these data are then shared through data aggregators such as Apple’s HealthKit that pools data from multiple health apps (Dinh-Le et al, 2019).

These devices have a wide range of benefits. They provide Real-time health monitoring of vital statistics, providing more timely data for analysis. Additionally, through these devices, earlier detection of disease or risk of a major health event has improved, preventing unnecessary deaths (Dinh-Le et al, 2019). Wearable devices also contribute to instant notification when biometric readings move into a risk zone. Further, there is also convenience of not having to schedule an office visit, especially during this pandemic period occasioned by lockdowns (Dinh-Le et al, 2019). Easy sharing of health data between remote patients and clinicians throughout the patient care ecosystem is also enhanced.

However, these devices still face a myriad of challenges which affect their application. Consider an issue such as a device malfunctioning and giving the wrong data. This could result in misinterpretation of results, leading to undesired consequences for both the patient and the physician (Dinh-Le et al, 2019). One of the primary benefits of wearable devices is the amount of data available for patients and doctors to analyze and to act upon. But, with that data comes the risk of data breaches and the stored information falling into the wrong hands. In conclusion, these devices have the potential of improving healthcare practice and related outcomes. They collected and analyze a vast amount of patient data using artificial intelligence and machine learning algorithms such as nearest neighbor search which allows for the early diagnosis of chronic conditions, ensuring the patient receives primary care early enough. The implication herein is they enhance preventive/proactive healthcare. NNS for example has been combined with logistic regression to develop wearable devices that enhance diagnostic processes in neonatal sepsis, reducing mortality rates significantly (Xiao et al, 2010).

References

Dinh-Le, C., Chuang, R., Chokshi, S., & Mann, D. (2019). Wearable Health Technology and Electronic

Health Record Integration: Scoping Review and Future Directions. JMIR mHealth and uHealth,

7(9), e12861. https://doi.org/10.2196/12861

Guk, K., Han, G., Lim, J., Jeong, K., Kang, T., Lim, E. K., & Jung, J. (2019). Evolution of Wearable Devices

with Real-Time Disease Monitoring for Personalized Healthcare. Nanomaterials (Basel,

Switzerland), 9(6), 813. https://doi.org/10.3390/nano9060813

Xiao, Y., Griffin, M. P., Lake, D. E., & Moorman, J. R. (2010). Nearest-neighbor and logisticregression analyses of clinical and heart rate characteristics in the early diagnosis of neonatal sepsis. Medical Decision Making, 30(2), 258-266.

Content

Name: NURS_8210_Week7_Discussion_Rubric

	Excellent	Good	Fair	Poor
RESPONSIVENESS TO DISCUSSION QUESTION Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
CONTENT KNOWLEDGE	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
CONTRIBUTION TO THE DISCUSSION	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
QUALITY OF WRITING	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.	Points Range: 5 (16.67%) – 5 (16.67%) Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.	Points Range: 4 (13.33%) – 4 (13.33%) Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.	Points Range: 0 (0%) – 3 (10%) Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
Total Points: 30

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTION

Discussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

CONTRIBUTION TO THE DISCUSSION

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

Points Range: 5 (16.67%) – 5 (16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

Points Range: 4 (13.33%) – 4 (13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

Points Range: 0 (0%) – 3 (10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

Total Points: 30