Search results for: hospital management

Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir

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The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.

Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin

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Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

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The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

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Authors: Pataraporn Kheawwan

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Preceptorship represents an important aspect in new nurse orientation. However, there was no formal preceptor training program developed for nurse preceptor in Thailand. The purposes of this study were to develop and evaluate formal preceptor training program for nurse preceptors in King Chulalongkorn Memorial Hospital, Thailand. A research and development study design was utilized in this study. Participants were 37 nurse preceptors. The program contents were delivered by e-learning material, class lecture, group discussion followed by simulation training. Knowledge of the participants was assessed pre and post program. Skill and critical thinking were assessed using Preceptor Skill and Decision Making Evaluation form at the end of program. Statistical significant difference in knowledge regarding preceptor role and coaching strategies between pre and post program were found. All participants had satisfied skill and decision making score after completed the program. Most of participants perceived benefits of preceptor training course. In conclusion, The results of this study reveal that the newly developed preceptorship course is an effective formal training course for nurse preceptors.

Keywords: preceptor, preceptorship, new nurse, clinical education

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Authors: Ruqayya Naheed Khan, Romaisa Shamim, Awais Amjad Malik, Awais Naeem, Amina Iqbal Khan, Asad Parvaiz

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Objective: Patients undergoing axillary lymph node dissection (ALND) for metastatic lymph nodes in our hospital usually have drains placed in their axilla for a period of 6-10 days. We evaluated the post-op course of patients who underwent breast conservation surgery (BCS) along with ALND. Methods: A prospective cohort study was conducted at Shaukat Khanam Memorial Cancer Hospital from April 2017 to August 2017 including all lymph node positive breast cancer patients undergoing BCS with ALND. Patients were divided into two groups. Group A had no axillary drain while in Group B a drain was placed in axilla. Results: A total of 76 patients were included. 41 patients were included in group A and 35 patients in Group B. Median number of LNs dissected in group A was 17 and in group B was 15 (p value 0.443). Median operative time in group A was 84 min and in group B was 79 min (p value 0.223). Median hospital stay in both groups was 1 day (p value 0.78). At 2 weeks all patients in group A developed seroma as compared to none in group B (p value < 0.001). 3 of these patients in group A required aspiration of seroma due to pressure effects. Rest were managed conservatively. At 6 weeks only 50% patients had a seroma radiologically in Group A as compared to 33% in group B (p value 0.023). No intervention was required in any patients at week 6. QOL at 2 weeks was much better in Group A (7/41 patients had unsatisfactory response) as compared to group B (10/31 had unsatisfactory response). Results were statistically significant (p value 0.045). However, there wasn’t much difference in QOL at 6 weeks. Only 1 patient in group A had an unsatisfactory response. Average pain score at 2 weeks was similar in both groups (4.2 v/s 4.1 p value 0.73). Infection was seen in 1 patient in each group at 2 weeks (p value 0.668) and in only 1 patient in group A at 6 weeks (p value 0.067). Conclusion: We conclude from our study that there isn’t much difference in drain and no drain group in terms of wound infection and pain scores. No drain group is however associated with a better QOL in early post-op period.

Keywords: axillary drainage, axillary lymph node dissection, breast cancer, no drain in axilla

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Authors: F. Demir

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Strategic Management is highly critical for all types of organizations. This paper examines maturity level of strategic management practices of public and private sector organizations in Turkey, and presents a conceptual model for assessing the maturity of strategic management in any organization. This research focuses on R&D intensive organizations (RDO) because it is claimed that such organizations are more innovative and innovation is a critical part of the model. The Strategic management maturity model (S-3M) is basically composed of six maturity levels with five different dimensions. Based on 63 organizations, the findings reveal that the average maturity of all organizations in the sample group is three out of five. It corresponds to the stage of ‘performed’. Results simply show that the majority of organizations from various industries and sectors implement strategic management activities; however, they experience multiple challenges to optimize strategic management processes and integrate organizational components with business strategies. Briefly, they struggle to become an innovative organization.

Keywords: strategic management maturity, innovation, developing countries, research and development

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Authors: Issa M. Hweidi, Saba W. Al-Ibraheem

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This study aimed to assess the increased hospital length of stay and healthcare costs associated with SSIs among ventriculoperitoneal shunting surgery patients in Jordan. This study adopted a retrospective and nested 1:1 matched case-control design. A non-probability convenient sample of 48 VP shunt patients was recruited for the purpose of the study. The targeted groups of the study basically used to cross-match the variables investigated to minimize the risk of confounding. Information was extracted from the text of patients' electronic health records. As compared to the non-SSI group, the SSI group had an extra mean healthcare cost of $13,696.53 (p=0.001) and longer hospital length of stay (22.64 mean additional days). Furthermore, Acinetobacter baumannii and Klebsiella pneumonia were identified as being the most predominant causative agents of SSIs. The results of this study may provide baseline data for national and regional benchmarking to evaluate the quality of care provided to likewise patients. Adherence to infection control strategies and protocols considering new surveillance methods of SSIs is encouraged.

Keywords: ventriculoperitoneal shunt, health care cost, length of stay, neurosurgery, surgical site infections

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Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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Authors: Gabriel Jinga, Madalina Dumitru

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The objective of this paper is to present the process of change in management accounting in Romania, a former communist country from Eastern Europe. In order to explain this process, we used the contingency and institutional theories. We focused on the following directions: the presentation of the scientific context and motivation of this research and the case study. We presented the state of the art in the process of change in the management accounting from the international and national perspective. We also described the evolution of management accounting in Romania in the context of economic and political changes. An important moment was the fall of communism in 1989. This represents a starting point for a new economic environment and for new management accounting. Accordingly, we developed a case study which presented this evolution. The conclusion of our research was that the changes in the management accounting system of the company analysed occurred in the same time with the institutionalisation of some elements (e.g. degree of competition, training and competencies in management accounting). The management accounting system was modelled by the contingencies specific to this company (e.g. environment, industry, strategy).

Keywords: management accounting, change, Romania, contingency and institutional theory

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Authors: Kwok Tak Kit

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Combating climate change is becoming a hot topic in various sectors. Building construction and infrastructure sectors contributed a significant proportion of waste and GHGs emissions in the economy of different countries and cities. Many types of research had conducted and discussed the topic of waste management and waste management being a macro-level control is well developed in the building and construction industry. However, there is little research and studies on the micro-level of waste management, “building construction material wastage management,” and fewer reviews about regulatory control in the building construction sector. In this paper, we will focus on the potentialities and importance of material wastage management and review the deficiencies of the current standard to take into account the reduction of material wastage in a systematic and quantitative approach.

Keywords: quantitative measurement, material wastage management plan, waste management, uncalculated waste, circular economy

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Authors: Phawida Wattanasoonthorn

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Ventilator-associated pneumonia is a serious infection found to be among the top three infections in the hospital. To investigate the effects of clinical practice guideline on knowledge and preventive practices of nursing personnel, and incidences of ventilator-associated pneumonia. A pre-post quasi-experimental study on 17 professional nurses, and 123 ventilator-associated pneumonia patients admitted to the surgical intensive care unit, and the accident and surgical ward of Songkhla Hospital from October 2013 to January 2014. The study found that after using the clinical practice guideline, the subjects’ median score increased from 16.00 to 19.00. The increase in practicing correctly was from 66.01 percent to 79.03 percent with the statistical significance level of .05, and the incidences of ventilator-associated pneumonia decreased by 5.00 percent. The results of this study revealed that the use of the clinical practice guideline helped increase knowledge and practice skill of nursing personnel, and decrease incidences of ventilator-associated pneumonia. Thus, nursing personnel should be encouraged, reminded and promoted to continue using the practice guideline through various means including training, providing knowledge, giving feedback, and putting up posters to remind them of practicing correctly and sustainably.

Keywords: Clinical Practice Guideline, knowledge, Preventive Ventilator, Pneumonia

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Authors: Wong Yat Cheung Maggie

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Occupational Safety and Health Ordinance (OS&HO) (Chap 509) was enacted in 1997, OHS in HK should be growing and maturing, with a holistic approach to occupational health and safety in the workplace including physical, mental, social and spiritual well-being. The question is “How effective are OHSPs in meeting the current needs of HK health workers?” This study was designed to explore the issue for the first time, to empirically analyse the views of those who work in the system. The study employed a mixed method approach to collect various data from Occupational Health Service Providers (OHSPs), Occupational Health Service Consumers (OHSC): Registered nurses working in the hospital setting. This study was designed in two phases and two stages. Phase I Stage I was a paper survey to collect the data on OHSP. Then Phase I Stage II was a follow-up interview. Phase II Stage I was a paper survey to collect the data on OHSC. Then Phase II Stage II was a follow-up focus group study on OHSC for further clarification of the Phase II and Stage I result. The Phase I result reflects HK OHSPs point of view and their experience in the existing OHS practice in the local hospitals. It reflects various styles of reporting systems, staff profiles background and resource in providing OHS in HK hospitals. However, the basic OHS concern is similar between hospitals. In general, the OHS policies and procedures are available on site even though they may have different foci. The Phase II result is reflecting the HKs OHSCs echoes the OHSP feedback at providing of OHS, OHS concern and related policies and procedure are available on site. However, the most significant feedback from the OHSC at Phase II Stage II shows, nurses experienced various OHS concern most commonly work stress, workplace harassment and back strain without formal or official report to the related parties. The lack of reporting was due to the management handling attitude, stakeholders’ compliance and term of definition still have room to be improved even the related policies and procedures are available on site.

Keywords: occupational health service, registered nurse, Hong Kong hospital, mixed method

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Authors: Salah Kayed Kayed, Jessica Hong Yang

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This study investigates, whether earnings management in the audited financial statements is associated with tone management in the narrative sections of the annual report in the UK. Earnings management and narrative disclosure are communication strategies used from managers to communicate with investors or other users. Because earnings management and narrative disclosure stem from managers, they can exploit this by doing manipulation in their earnings, and simultaneously disclosing qualitative text (narrative information) in their reports as a tone of words, which will affect users’ perception, and hence users will be misinformed. The association between earnings and tone management can be explained by the self-serving, through cognitive reference points, theory. The sample period lasts from 2010 to 2015, and the sample comprises all non-financial firms that consider under FTSE 350 in any year during the sample period. A list of words from previous research is used to measure the tone in the narrative sections of the annual report. Because this study focuses on the managerial strategic choice and the subjective issues that come from management, it uses the abnormal tone to capture the managerial discretion on tone, and a number of different discretionary accruals proxies to measure earnings management, where accruals management is considered as a manipulation tool from managers to change the users' perception. This research is motivated to fulfil the literature gap by examining the association between earnings and tone management. Moreover, if firms that apply earnings management use tone management to mislead investors, it is beneficial for investors, policy makers, standard setters, or other users to know whether there is an association between earnings management and tone management. Clearly, we believe that this study is fundamental in the accounting context, where it evaluates the communication strategies that are used in firms' financial reports. Consistent with prior research, it is expected that tone management is positively associated with earnings management. This means that firms that use earnings management have incentives to manipulate in their narrative disclosure through tone of words, to reflect a good perception for users, which will conceal the earnings management techniques used in their reporting.

Keywords: earnings management, FTSE 350, narrative disclosure, tone management

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Authors: Cletus Agbowo

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Standard principles, rules, regulations, norms and guides are necessities in practice especially in the Economics and management information system Institute of management of and technology (IMT) Enugu a case sturdy as presented by the presenter. Without mincing words, the fundamental bottle neck of management is economics, how to select to engage merger productivity resources to achieve uncountable objectives without tears. Management information system inevitably become bound up in organizational politics because the influence access to a key resource – namely information. Economics and management information can effect who does what to whom, when, where and how in an organization. In great institutions like the Institute of Management and Technology (IMT) Enugu a case study many new information systems require changes in personnel, individual routines that can be painful for those involved and require retraining and additional effort may or may not be compensated. In a nut shell, because management information system potentially change an organization’s structure, culture, business processes, and strategy, there is often considerable resistance to them when they are introduced. The case study have many schools, departments, divisions and units which needs research on economics and management information systems. A system can be defined as a set of interrelated components and / or elements, which reacts with input to produce output. A department in an organization is a system. The researcher is faced to itemize the practical challenges encountered and solution adopted by the Institute Management and Enugu state government.

Keywords: economics, information, management, productivity, regulations

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Authors: Ihn Sook Jeong, Eun Joo Lee, Jae Hyung Kim, Gun Ho Kim, Young Jun Hwang

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This study investigated intravenous (IV) infiltration using bioelectrical impedance for 27 hospitalized patients in a long-term care hospital. Impedance parameters showed significant differences before and after infiltration as follows. First, the resistance (R) after infiltration significantly decreased compared to the initial resistance. This indicates that the IV solution flowing from the vein due to infiltration accumulates in the extracellular fluid (ECF). Second, the relative resistance at 50 kHz was 0.94 ± 0.07 in 9 subjects without infiltration and was 0.75 ± 0.12 in 18 subjects with infiltration. Third, the magnitude of the reactance (Xc) decreased after infiltration. This is because IV solution and blood components released from the vein tend to aggregate in the cell membrane (and acts analogously to the linear/parallel circuit), thereby increasing the capacitance (Cm) of the cell membrane and reducing the magnitude of reactance. Finally, the data points plotted in the R-Xc graph were distributed on the upper right before infiltration but on the lower left after infiltration. This indicates that the infiltration caused accumulation of fluid or blood components in the epidermal and subcutaneous tissues, resulting in reduced resistance and reactance, thereby lowering integrity of the cell membrane. Our findings suggest that bioelectrical impedance is an effective method for detection of infiltration in a noninvasive and quantitative manner.

Keywords: intravenous infiltration, impedance, parameters, resistance, reactance

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Authors: Eltayeb Hamad Elneel Yousif

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This paper describes occupational radiation doses of workers in non-destructive testing (NDT) and some medical practices during the year 2007. The annual doses received by the workers of a public hospital are presented in this report. The Department is facilitated with HARSHAW Reader model 6600 and assigned the rule of personal monitoring to contribute in controlling and reducing the doses received by radiation workers. TLD cards with two TLD chips type LiF: Mg, Ti (TLD-100) were calibrated to measure the personal dose equivalent Hp(10). Around 150 medical radiation workers were monitored throughout the year. Each worker received a single TLD card worn on the chest above lead apron and returned for laboratory reading every two months. The average annual doses received by the workers of radiotherapy, nuclear medicine and diagnostic radiology were evaluated. The annual doses for individual radiation workers ranged between 0.55-4.42 mSv, 0.48-1.86 mSv, and 0.48-0.91 mSv for the workers of radiotherapy, nuclear medicine and diagnostic radiology, respectively. The mean dose per worker was 1.29±1, 1.03±0.4, and 0.69±0.2 mSv, respectively. The results showed compliance with international dose limits. Our results reconfirm the importance of personal dosimetry service in assuring the radiation protection of medical staff in developing countries.

Keywords: radiation medicine, non-destructive testing, TLD, public hospital

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Authors: Hitham Yami

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This study will focus primarily on assessing the availability requirements of the electronic management of oil companies in Libya, and the mean objectives of the research applying electronic management and make recommendations and steps to approach electronic management. There are limited research and statistical analysis to support electronic management in Libyan companies. The groundwork for the proposed approach is to develop independent variables and the dependent variables to be restructured after it Alntra side of the field and the side to get the data to achieve the desired results and solving the problem faced by the Libyan Oil Corporation. All these strategies are proposed to achieve the goal, and solving Libyan oil installations.

Keywords: oil company’s revenue, independent variables, electronic management, Libyan oil corporation

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Authors: Khlif Hamadi

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The principal aim of our research is to analyze the impact of the adoption of e-management approach on the performance of Tunisian firms. The method of structural equation was adopted to conduct our exploratory and confirmatory analysis. The results arising from the questionnaire sent to 155 E-managers affirm that the adoption of e-management approach influences the performance of Tunisian firms. The results of the questionnaire show that e-management favors the deployment of ICT usage and contributes enormously to the performance of the modern enterprise. The theoretical and practical implications of the study, as well as directions for future research, are discussed.

Keywords: e-management, ICT Deployment, organizational performance, e-manager

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Authors: Harsh Panchal, Saurabh Amrutkar

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Quality management is an essential part of any project that has directly related to the performance of a project. Quality management is depended on multiple factors at different stages in a project, right from time management to construction logistics. A project is a mixture of various components that include iternary management, health and safety, crew productivity, and many more. From the survey conducted, we came to the conclusion that advancement in technology and indigenous approach to any project will result in maximum quality standards and better project performance. In this paper, we discuss various components of the factors above that lead to compromise the quality of a project and how it can be controlled in order to achieve maximum quality assurance using quality planning and total quality management. The paper also focuses on limitations and problems faced in each factor responsible for quality management and to tackle them using techniques and processes based on activities and identifying the sequence, approaching critical path, and duration. The project management concept that deals with the sequence of scope cost time give us an overview regarding the ongoing quality management, in a nutshell, giving us hints to regulate the current procedure for maximum achievable quality. It also deals with the problems faced by engineers that make the mundane work process slow, reducing the quality outcome drastically.

Keywords: management, performance, project, quality

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Authors: Jagoda Bruni, Jan Müller-Lucanus, Gernot Stöger-Knes

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The purpose of this article is to demonstrate modern project management approaches in the SAP S/R Hana surrounding a programming environment composed of multiple focus-diversified projects. We would like to propose innovative and goal-oriented management standards based on the specificity of the SAP transformations and customer-driven expectations. Due to the regular sprint-based controlling and management tools' application, it has been data-proven that extensive analysis of productive hours of the employees as much as a thorough review of the project progress (per GAP, per business process, and per Lot) within the whole program, can have a positive impact on customer satisfaction and improvement for projects' budget. This has been a collaborative study based on real-life experience and measurements in collaboration with our customers.

Keywords: project management, program management, SAP, controlling

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Authors: Abdul Amir Hazbavi

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In recent years, there have been increasing requests in the field of translation studies to develop software facilitating the analysis of corpora. One of the specialized tools in that regard are Terminology Management Tools. Briefly explaining, Terminology Management Tools are applications developed to help create and store terminological data in the form which allows for a controlled use of the data. While it has a long history and an established ground in translation market in most parts of the globe, the Iranian translators and translation market still seem to be unaware or unfamiliar with Terminology Management Tools. In order to provide a preview on the perception and adoption of Terminology Management Tools by the Iranian translators, the present survey was carried out among 224 last-year undergraduate Iranian students of English translation at 10 different universities across the country. The study revealed a very low level of adoption and a very high level of willingness to get familiar with and learn about Terminology Management Tools by the Iranian translators.

Keywords: translation, translation technology, terminology management tools, terminology management survey

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Authors: Sarbjit Singh

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This framework development explored the status of GSCM in manufacturing SMEs and concluded that there was a significant gap w.r.t carbon emissions measurement in the supply chain activities. The measurement of carbon emissions within supply chains is important green initiative toward its reduction. The majority of the SMEs were facing the problem to quantify the green house gas emissions in its supply chain & to make it a low carbon supply chain or GSCM. Thus, the carbon management initiatives were amalgamated with the supply chain activities in order to measure and reduce the carbon emissions, confirming the GHG protocol scopes. Henceforth, it covers the development of carbon management software (CMS) tool to quantify carbon emissions for effective carbon management. This tool is cheap and easy to use for the industries for the management of their carbon emissions within the supply chain.

Keywords: w.r.t carbon emissions, carbon management software, supply chain management, Indian Industry

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Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

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Authors: Ketevan Kokrashvili, Rusudan Kutateladze, Nino Pailodze

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Importance of management of legal entities under private law of which especially corporate management, as well as looking for ways of its improvement and perfection has become especially relevant in the twenty-first century, which was greatly contributed to by the global economic crisis. Some states have adopted Corporate Governance Codes; the European Union has set to work on a series of directives the main purpose of which is an improvement of corporate governance, provision of greater transparency and implementation of an effective control mechanism. This process is not yet completed, and various problematic issues associated with management of legal persons are still being debated among practitioner experts and scholars. Georgia is not an exception in this regard. The article discusses the legislative gaps, and in some cases, discrepancies having arisen in legal relationships under private law and having caused many practical problems. This especially applies to the management of capital companies.

Keywords: business entities, corporate management, capital public management, existing problems, legal discrepancies

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Authors: Rahul Jain, Jagdish Chander, Anish Gupta

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Introduction: Laparoscopic common bile duct exploration (LCBDE) allows cholecystectomy and the removal of common bile duct (CBD) stones to be performed during the same sitting, thereby decreasing hospital stay. CBD exploration through choledochotomy can be closed primarily with an absorbable suture material, but can lead to biliary leakage postoperatively. In this study we tried to find a solution to further lower the incidence of bile leakage by using fibrin glue to reinforce the sutures put on choledochotomy suture line. It has haemostatic and sealing action, through strengthening the last step of the physiological coagulation and biostimulation, which favours the formation of new tissue matrix. Methodology: This study was conducted at a tertiary care teaching hospital in New Delhi, India, from 2011 to 2013. 20 patients with CBD stones documented on MRCP with CBD diameter of 9 mm or more were included in this study. Patients were randomized into two groups namely Group A in which choledochotomy was closed with polyglactin 4-0 suture and suture line reinforced with fibrin glue, and Group ‘B’ in which choledochotomy was closed with polyglactin 4-0 suture alone. Both the groups were evaluated and compared on clinical parameters such as operative time, drain content, drain output, no. of days drain was required, blood loss & transfusion requirements, length of postoperative hospital stay and conversion to open surgery. Results: The operative time for Group A ranged from 60 to 210 min (mean 131.50 min) and Group B 65 to 300 min (mean 140 minutes). The blood loss in group A ranged from 10 to 120 ml (mean 51.50 ml), in group B it ranged from 10 to 200 ml (mean 53.50 ml). In Group A, there was no case of bile leak but there was bile leak in 2 cases in Group B, minimum 0 and maximum 900 ml with a mean of 97 ml and p value of 0.147 with no statistically significant difference in bile leak in test and control groups. The minimum and maximum serous drainage in Group A was nil & 80 ml (mean 11 ml) and in Group B was nil & 270 ml (mean 72.50 ml). The p value came as 0.028 which is statistically significant. Thus serous leakage in Group A was significantly less than in Group B. The drains in Group A were removed from 2 to 4 days (mean: 3 days) while in Group B from 2 to 9 days (mean: 3.9 days). The patients in Group A stayed in hospital post operatively from 3 to 8 days (mean: 5.30) while in Group B it ranged from 3 to 10 days with a mean of 5 days. Conclusion: Fibrin glue application on CBD decreases bile leakage but in statistically insignificant manner. Fibrin glue application on CBD can significantly decrease post operative serous drainage after LCBDE. Fibrin glue application on CBD is safe and easy technique without any significant adverse effects and can help less experienced surgeons performing LCBDE.

Keywords: bile leak, fibrin glue, LCBDE, serous leak

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Authors: Azmi Ilmi Aziz, Wisnu Sadasih, Rizal Fanany

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Purpose: This study describes systemic factors, intraocular lens (IOL), and ocular abnormalities in patients with IOL glistening at a tertiary hospital in Semarang. Methods: A retrospective, with a descriptive approach on patients with IOL glistening who visited the eye clinic between August 2019 to June 2023. Results: Twenty-five patients were examined; 11 patients (44%) had IOL glistening in their right eye, 4 patients (16%) in their left eye, and 10 patients (40%) in both eyes. The gender of patients consisted of 12 male patients (48%) and 13 female patients (52%). The median age of the patients was 68 years. The mean onset was 4.44 years after the first cataract surgery. Hypertension was found in 13 patients (52%), and diabetes was found in 9 patients (36%). Nine patients (36%) were identified with a foldable IOL with a closed loop design, and 1 patient (4%) with a PMMA IOL with an iris-fixated IOL design, while 15 other patients’ IOL were unrecorded. Glaucoma was found in 3 patients (12%). Conclusions: The result of this study showed that more than half of the patients were hypertensive, and some were glaucomatous, which had been discussed relevant in previous studies. Most IOL that could be identified was foldable IOL with a closed loop design. To our knowledge, the design of an IOL to glistening had never been explored. A longer study involving larger subjects is needed to better describe the systemic factors, IOL, and ocular abnormalities in patients with IOL glistening.

Keywords: glistening, intraocular lens, foldable IOL, PMMA IOL

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Authors: Ali Bakari Mohammed

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Transitioning is a continuous process of radical change in a society which involves co-evolution of institutional, technological, socio-cultural, and ecological developments at different scales and levels. Transition management model is a methodology that influences structural change of complex systems over a period (0-30 years) by experimenting and implementing new techniques. A transition management in the context of groundwater is a radical change from the current operate and control system to a next generation integrated and sustainable system that takes into account quality protection and sustained supply into the future. This study evaluates the transition management model in adopting it as a viable tool for the attainment of sustainable groundwater management. The outcome of the evaluation shows that there are three levels (strategic, tactical and operational) of operating the transition management model. At the strategic level, long-term goals for sustainable groundwater management are formulated, at the tactical level activities such as inter institutional networking, negotiation, planning and financing are carried out, and at the operational level, transition experiments and strategic niche management are carried out at the societal level. Overall, different actors and set of activities are required to partake at each management level. The outcome of this paper will provide basis for the implementation of the Sustainable Development Goal (SDG) 6 in Nigeria.

Keywords: transition management, groundwater, sustainable management, tool, Nigeria

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Authors: Fatemeh Jaferi, Moslem Parsa, Seyed Mehdi Sajadi

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The project-oriented organizations are more appropriate for sustainable environments. Any effective project-oriented organization should institutionalize its project management processes in such a manner to yield the greatest possible profits. The aim of this paper is to study the relationship between the project management PMBOK guideline (Project Management Body of Knowledge) and simulation technology in project-oriented organizations. The methodology involves using five steps for applying these two tools aimed at enhancing project management processes in the Lorestan Gas Corporation, as one of the project-oriented organization. Results show the implementation of such management approach leads to a 5% performance improvement and using PMBOK can be instrumental in effective delay management. The implementation of the aforementioned improvement package was effective in improving the efficiency of organizational processes; in terms of optimizing the resource utilization that has manifested itself in resource losses and cost reductions.

Keywords: project-orientation, processes, PMBOK, optimization, organization, management

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Authors: Sunny Deo, Eve Barnes, Peter Arnold-Smith

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Introduction: Healthcare technology is a rapidly expanding field in healthcare, with enthusiasts suggesting a revolution in the quality and efficiency of healthcare delivery based on the utilisation of better e-healthcare, including the move to paperless healthcare. The role and use of computers and programmes for healthcare have been increasing over the past 50 years. Despite this, there is no standardised method of assessing the quality of hardware and software utilised by frontline healthcare workers. Methods and subjects: Based on standard Patient Related Outcome Measures, a questionnaire was devised with the aim of providing quantitative and qualitative data on clinicians’ perspectives of their hospital’s Information Technology (IT). The survey was distributed via the Institution’s Intranet to all contracted doctors, and the survey's qualitative results were analysed. Qualitative opinions were grouped as positive, neutral, or negative and further sub-grouped into speed/usability, software/hardware, integration, IT staffing, clinical risk, and wellbeing. Analysis was undertaken on the basis of doctor seniority and by specialty. Results: There were 196 responses, with 51% from senior doctors (consultant grades) and the rest from junior grades, with the largest group of respondents 52% coming from medicine specialties. Differences in the proportion of principle and sub-groups were noted by seniority and specialty. Negative themes were by far the commonest stated opinion type, occurring in almost 2/3’s of responses (63%), while positive comments occurred less than 1 in 10 (8%). Conclusions: This survey confirms strongly negative attitudes to the current state of electronic documentation and IT in a large single-centre cohort of hospital-based frontline physicians after two decades of so-called progress to a paperless healthcare system. Greater use would provide further insights and potentially optimise the focus of development and delivery to improve the quality and effectiveness of IT for clinicians and their patients.

Keywords: information technology, electronic patient records, digitisation, paperless healthcare

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Authors: Yvonne Nanaama Brew, Bismark Jampim Abrokwah

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Children with disabilities in Ghana are not routinely registered, and this can imply that they may be neglected in national policy planning since global estimates may not be near the exact numbers. Although there are some studies with reports on the prevalence of disability among children in Ghana, reliable information on the prevalence, types of disability in children, and children who die with disabilities in the Greater Accra region are lacking. The current study seeks to investigate the incidence of disability among children two to fourteen years at selected districts in the Greater Accra region of Ghana. A cross-sectional design is adapted with a quantitative method for this study. Parents with disabled children who access child welfare clinics at the Greater Accra regional hospital, Maamobi hospital, Ga west, and Ga south district hospitals will be selected through purposive sampling for the study. An adapted UNICEF structured Ten Questions will be used to collect relevant data about participants. The responses to the questions will be either 'Yes' or 'No'. Parents with children who answer 'Yes' to a disability and purposively sampled parents with children who answer 'No' to disability will be invited to Child Health Clinic at the Greater Accra regional hospital for a free clinical assessment. Data will be entered into Microsoft Office Excel 2013 and imported into STATA version 15 for analysis. The study is expected to provide reliable disaggregated data on less than fourteen years of children with disabilities in the Greater Accra region. The findings and recommendations of the study will demonstrate the importance of early detection of disability and facilitate more quality and holistic planning of appropriate programmes that best safeguard the rights of children with disabilities in Ghana. It will help in policy and decision-making on children less than fourteen years with disabilities in Ghana. Also, findings will be useful for health facilities in Ghana to plan services for disabled children. Finally, the study is expected to add to the guides for the National Council of Persons with Disabilities to fulfill its legal mandate for disabled persons in Ghana.

Keywords: prevalence, disability, children, Ghana

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Authors: Chengxuan Geng, Yizhou E

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This paper mainly examines the changes in the relationship between earnings management and audit quality before and after financial crisis in the context of American firms from 2005 to 2010. Based on a sample of 3584 firm year observations, we find that there are changes concerning the relation between accrual-based earnings management and audit quality during the pre-crisis and post-crisis periods. However, the results do not provide enough evidence with regard to the variances in the association between real activities earnings management and audit quality during these two periods.

Keywords: audit quality, earnings management, financial crisis, relationship

Procedia PDF Downloads 321