Search results for: clinical staff

Authors: Reza Zarei

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The result of the present study is to determine the relation between spiritual intelligence and organizational health and job satisfaction among the female staff in Islamic Azad University of Marvdasht. The population of the study includes the female staff and the faculty of Islamic Azad University of Marvdasht. The method is correlational and the instrument in the research is three questionnaires namely the spiritual intelligence by (ISIS), Amraam and Dryer, organizational health by Fieldman and Job satisfaction questionnaire. In order to test the hypotheses we used interpretive statistics, Pearson and regression correlation coefficient. The findings show that there is a significant relation between the spiritual intelligence and organizational health among the female staff of this unit. In addition, the organizational health has a significant relation with the elements of self-consciousness and social skills and on the other hand, job satisfaction is in significant relation with the elements of self-consciousness, self-control, self-provocation, sympathy and social skills in the whole sample regardless of the participants' gender. Finally, the results of multiple regression and variance analysis showed that using the variables of the spiritual intelligence of the female staff could predict the organizational health and their job satisfaction.

Keywords: job satisfaction, spiritual intelligence, organizational health, Islamic Azad University

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Authors: Tsung Chin Wu, Yu Chen Tsai, Rhay Hung Weng, Weir Sen Lin

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In recent years, nursing staff’s lower job satisfaction has led to higher turnover rates, and high turnover rates not only cause medical institution costs to increase but also the quality of medical care to decrease. From the perspective of internal marketing, institution staffs are internal customers, and institutions should focus and meet the needs of staff, so that staff will strive to meet the needs of external customers and provide them with the required care. However, few previous studies have investigated the impact of internal staff satisfaction on external customers. Therefore, this study aimed to conduct job satisfaction surveys on internal staff to investigate the relationship between job satisfaction and quality of medical care through statistical analysis of the study results. The related study results may serve as a reference for healthcare managers. This study was conducted using a questionnaire and the subjects were nursing staff from four hospitals. A total of 600 questionnaires were distributed and 577 valid questionnaires were returned with a response rate of 96.1%. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The impact of internal marketing and job satisfaction on turnover intention of nursing staff was analyzed using descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. The study results showed that there was a significant difference between nursing staff’s job title and ‘professional participation’ and ‘shifts’. There was a significant difference between salary and ‘shifts’ and ‘turnover intention’, as well as between marriage and ‘remuneration’ and ‘turnover intention’. A significant difference was found between professional advancement and ‘professional growth’ and ‘type of leave’, as well as between division of service and ‘shifts’ and ‘turnover intention’. Pearson correlation analysis revealed a significant negative correlation between turnover intention and ‘internal marketing’, ‘interaction’, ‘professional participation’, ‘grasp of environment’, ‘remuneration’ and ‘shifts’, meaning that the higher the satisfaction, the lower the turnover intention. It is recommended that hospitals establish a comprehensive internal marketing mechanism to enhance staff satisfaction and in turn, reduce intention to resign, and the key to increasing job satisfaction is by establishing effective methods of internal communication.

Keywords: internal marketing, job satisfaction, turnover intention, nursing staff

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Authors: Tohid Eskandarzadeh, Nader Bahlouli, Turaj Behnam, Azra Jafarzadeh

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The purpose of the study reported in this paper was to propose an optimal pattern to evaluate the staff management performance of the water and sewage organization. The performance prism-model was used to evaluate the following significant dimensions of performance: organizational strategies, organizational processes, organization capabilities, stakeholders’ partnership and satisfaction. In the present study, a standard, valid and reliable questionnaire was used to obtain data about the five dimensions of the performance prism model. 169 sample respondents were used for responding the questionnaire who were selected from the staff of water and waste-water organization in western Azerbaijan, Iran. Also, Alpha coefficient was used to check the reliability of the data-collection instrument which was measured to be beyond 0.7. The obtained data were statistically analyzed by means of SPSS version 18. The results obtained from the data analysis indicated that the performance of the staff management of the water and waste-water organization in western Azerbaijan was acceptable in terms of organizational strategies, organizational process, stakeholders’ partnership and satisfaction. Nevertheless, it was found that the performance of the staff management with respect to organizational abilities was average. Indeed, the researchers drew the conclusion that the current performance of the staff management in this organization in western Azerbaijan was less than ideal performance.

Keywords: performance evaluation, performance prism model, water, waste-water organization

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Authors: Auni Idi Muhire

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Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

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Authors: Cheng Sim Quah, Sandra Phek Lin Sim

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This study examined how individuals in their respective teams contributed to innovation performance besides defining the term of innovation in their own respective views. This study also identified factors that motivated University staff to contribute to the innovation products. In addition, it examined whether there is a significant relationship between professional training level and the length of service among university staff towards innovation and to what extent do the two variables contributed towards innovative products. The significance of this study is that it revealed the strengths and weaknesses of the university staff when contributing to innovation performance. Stratified-random sampling was employed to determine the samples representing the population of lecturers in the study, involving 123 lecturers in one of the local universities in Malaysia. The method employed to analyze the data is through categorizing into themes for the open-ended questions besides using descriptive and inferential statistics for the quantitative data. This study revealed that two types of definition for the term “innovation” exist among the university staff, namely, creation of new product or new approach to do things as well as value-added creative way to upgrade or improve existing process and service to be more efficient. This study found that the most prominent factor that propel them towards innovation is to improve the product in order to benefit users, followed by self-satisfaction and recognition. This implies that the staff in the organization viewed the creation of innovative products as a process of growth to fulfill the needs of others and also to realize their personal potential. This study also found that there was only a significant relationship between the professional training level and the length of service of 4-6 years among the university staff. The rest of the groups based on the length of service showed that there was no significant relationship with the professional training level towards innovation. Moreover, results of the study on directional measures depicted that the relationship for the length of service of 4 - 6 years with professional training level among the university staff is quite weak. This implies that good organization management lies on the shoulders of the key leaders who enlighten the path to be followed by the staff.

Keywords: innovation, length of service, performance, professional training level, motivation

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Authors: Robin Becker, Nane Roetmann, Manfred Helmus

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Construction companies lack junior staff for construction management. According to a nationwide survey of students, however, the profession lacks attractiveness. The conflict between the traditional job profile and the current desires of junior staff for contemporary and flexible working models must be resolved. Increasing flexibility is essential for the future viability of small and medium-sized enterprises. The implementation of modern work modules can help here. The following report will present the validation results of the developed work modules in construction practice.

Keywords: modern construction management, construction industry, work modules, shortage of junior staff, sustainable personnel management, making construction management more attractive, working time model

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Authors: Nasrullah khan

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Today business environment is very dynamic and most of organizations are in tough competition for their added values and sustainable hold in market. To achieve such objectives, organizations must have dynamic and creative people as optimized process. To get these people, there should strong human resource management system in organizations. There are multiple approaches have been devised in literature to hire more job relevant and more suitable people. This study proposed an ANP (Analytic Network Process) approach to hire faculty members for a university system. This study consists of two parts. In fist part, a through literature survey and universities interview are conducted in order to find the common criteria for the selection of academic staff. In second part the available candidates are prioritized on the basis of the relative values of these criteria. According to results the GRE & foreign language, GPA and research paper writing were most important factors for the selection of academic staff.

Keywords: creative people, ANP, academic staff, business environment

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Authors: Jessica Hemberg, Mikaela Miller

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Unreasonable workload and work-related stress can reduce nurse leaders’ job satisfaction and productivity and can increase absence and burnout. Nurse leaders’ workload in public healthcare settings is relatively unresearched. The aim of this study was to investigate nurse leaders’ perceptions of workload and task distribution with relation to leading work tasks in public healthcare. A qualitative explorative design was used. The data material consisted of texts from interviews with nurse leaders in public healthcare (N=8). The method was inspired by content analysis. The COREQ checklist was used. Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Six main themes were found: Increased and unreasonable workload, Length of work experience as nurse leader affects perception of workload, Number of staff and staff characteristics affect perception of workload, Versatile and flexible task distribution, Working overtime as a way of managing high workload, and Insufficient time for leadership mission. The workload for nurse leaders in a public healthcare setting was perceived to be unreasonable. Common measures for managing high workload included working overtime, delegating work tasks and organizing more staff resources in the form of additional staff. How nurse leaders perceive their workload was linked to both the number of staff and staff characteristics. These should both be considered equally important when determining staff levels and measuring nurse leaders’ workload. Future research should focus on investigating workload and task distribution from nurses’ perspectives.

Keywords: nurse leaders, workload, task distribution, public healthcare, qualitative

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Authors: Khaled M. Alhawiti

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This paper investigates the future of medicine and the use of Natural language processing. The importance of having correct clinical information available online is remarkable; improving patient care at affordable costs could be achieved using automated applications to use the online clinical information. The major challenge towards the retrieval of such vital information is to have it appropriately coded. Majority of the online patient reports are not found to be coded and not accessible as its recorded in natural language text. The use of Natural Language processing provides a feasible solution by retrieving and organizing clinical information, available in text and transforming clinical data that is available for use. Systems used in NLP are rather complex to construct, as they entail considerable knowledge, however significant development has been made. Newly formed NLP systems have been tested and have established performance that is promising and considered as practical clinical applications.

Keywords: clinical information, information retrieval, natural language processing, automated applications

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Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: cancer patients, e-learning, nursing, web based education

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Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

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Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

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Authors: Luke Power, Paul O'Leary

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Research has long described the enhancement of student engagement as a fundamental aim of delivering a consistent, lifelong benefit to student success across the multitude of dimensions a quality HE (higher education) experience offers. Engagement may take many forms, with Universities and Institutes across the world attempting to define the parameters which constitutes a successful student engagement framework and implementation strategy. These efforts broadly include empowering students, encouraging involvement, and the transfer of decision-making power through a variety of methods with the goal of obtaining a meaningful partnership between students and staff. As the Republic of Ireland continues to observe an increasing population transferring directly from secondary education to HE institutions, it falls on these institutions to research and develop effective strategies which insures the growing student population have every opportunity to engage with their education, research community, and staff. This research systematically reviews SPAs (student partnership agreements) which are currently in the process of being defined, and/or have been adopted at HE institutions, worldwide. Despite the demonstrated importance of a student-staff partnership to the overall student engagement experience, there is no obvious framework or model by which to begin this process. This work will therefore provide a novel analysis of student-staff agreements which will focus on examining the factors of success common to each and builds towards a workable and applicable framework using critical review, analysis of the key words, phraseology, student involvement, and the broadly applicable HE traits and values. Following the analysis, this work proposes SPA ‘toolkit’ with input from key stakeholders such as students, staff, faculty, and alumni. The resulting implications for future research and the lessons learned from the development and implementation of the SPA will aid the systematic implementation of student-staff agreements in Ireland and beyond.

Keywords: student engagement, student partnership agreements, student-staff partnerships, higher education, systematic review, democratising students, empowering students, student unions

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Authors: Mai Ali

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Background: Preparing Hypo-screen-bags in advance streamlines the time-consuming process of administering glucose systemic correction. Additionally, Hypo-Screen Grab Bags are widely adopted in UK hospitals. Aim: The aim of the study is to improve hypoglycemia screening efficiency and equipment accessibility by streamlining item access to grab bag restocking staff. Methodology: The study centered on neonatal wards at LGI & St. James Neonatal Unit and related units. A web-based survey was conducted to evaluate local practices, gathering 21 responses from relevant general staff. The survey outcomes: (1) The demand for accessible grab bags is evident for smoother processes. (2) The potential to enhance efficiency through improved preparation of hypo-screen grab bags. Intervention: A Hypo-Screen Grab Bag was designed, including checklists for stocked items and required samples. Medical staff oversee restocking after use. Conclusion: The study successfully improved hypoglycemia screening efficiency and aided junior staff with accessible supplies and a user-friendly checklist.

Keywords: neonatal hypoglycemia, grab bag, hypo-screening, junior staff

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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Authors: Amizawati Mohd Amir, Ruhanita Maelah, Zaidi Mohd Noor

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As part of the Malaysia Higher Institutions' Strategic Plan in promoting high-quality research and education, the Ministry of Higher Education has introduced various instrument to assess the universities performance. The aims are that university will produce more commercially-oriented research and continue to contribute in producing professional workforce for domestic and foreign needs. Yet the spirit of the success lies in the commitment of university particularly the academic staff to translate the vision into reality. For that reason, the element of fairness and justice in assessing individual academic staff performance is crucial to promote directly linked between university and individual work goals. Focusing on public research universities (RUs) in Malaysia, this study observes at the issue through the practice of university contemporary performance measurement system. Accordingly management control theory has conceptualized that contemporary performance measurement consisting of three dimension namely strategic, comprehensive and dynamic building upon equity theory, the relationships between contemporary performance measurement system and organizational justice and in turn the effect on academic staff work performance are tested based on online survey data administered on 365 academic staff from public RUs, which were analyzed using statistics analysis SPSS and Equation Structure Modeling. The findings validated the presence of strategic, comprehensive and dynamic in the contemporary performance measurement system. The empirical evidence also indicated that contemporary performance measure and procedural justice are significantly associated with work performance but not for distributive justice. Furthermore, procedural justice does mediate the relationship between contemporary performance measurement and academic staff work performance. Evidently, this study provides evidence on the importance of perceptions of justice towards influencing academic staff work performance. This finding may be a fruitful input in the setting up academic staff performance assessment policy.

Keywords: comprehensive, dynamic, distributive justice, contemporary performance measurement system, strategic, procedure justice, work performance

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Authors: Lawal Kado

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This paper investigates the perceptions of academic staff at Umaru Musa Yar’adua University regarding the influences of librarians and working colleagues on the awareness and use of electronic databases. The study aims to provide insights into the effectiveness of these influences and suggest strategies to improve the usage of electronic databases. Research aim: The aim of this study is to determine the perceptions of academic staff on the influence of librarians and working colleagues towards the awareness and use of electronic databases in Umaru Musa Yar’adua University, Katsina. Methodology: The study adopts a quantitative method and survey research design. The survey questionnaire is distributed to 110 respondents selected through simple random sampling from a population of 523 academic staff. The collected data is analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Findings: The study reveals a high level of general awareness of electronic databases in the university, largely influenced by librarians and colleagues. Librarians have played a crucial role in making academic staff aware of the available databases. The sources of information for awareness include colleagues, social media, e-mails from the library, and internet searching. Theoretical importance: This study contributes to the literature by examining the perceptions of academic staff, which can inform policymakers and stakeholders in developing strategies to maximize the use of electronic databases. Data collection and analysis procedures: The data is collected through a survey questionnaire that utilizes the Likert scaling technique. The closed-ended questions are analyzed using SPSS 23. Question addressed: The paper addresses the question of how librarians and working colleagues influence the awareness and use of electronic databases among academic staff. Conclusion: The study concludes that the influence of librarians and working colleagues significantly contributes to the awareness and use of electronic databases among academic staff. The paper recommends the establishment of dedicated departments or units for marketing library resources to further promote the usage of electronic databases.

Keywords: awareness, electronic databases, academic staff, unified theory of acceptance and use of technology, social influence

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Authors: Olga C. Rodrigue

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Long-term care and skilled nursing facilities experience ebbs and flows of nursing staffing, a problem compounded by the perception of the facilities as undesirable workplaces and competition for staff from other healthcare entities. Travel nurses are contracted to fill staffing needs due to increased admissions, increased and unexpected attrition of nurses, or facility expansion of services. Prior to beginning the contracted assignment, the travel nurse must meet industry, company, and regulatory requirements (The Joint Commission and CMS) for skills and knowledge. Travel nurses, however, inconsistently receive the pre-assignment orientation needed to work at the contracted facility, if any information is given at all. When performance expectations are not met, travel nurses may subsequently choose to leave the position without completing the terms of the contract, and some facilities may choose to terminate the contract prior to the expected end date. The overarching goal of the Doctor of Nursing Practice evidence-based practice improvement project is to provide travel nurses with the basic and necessary information to prepare them to begin a long-term and skilled nursing assignment. The project involves the identification of travel nurse learning needs through a survey and the development and provision of web-based learning modules to address those needs prior to arrival for a long-term and skilled nursing assignment.

Keywords: nurse staffing, travel nurse, travel staff, contract staff, contracted assignment, long-term care, skilled nursing, onboarding, orientation, staff development, supplemental staff

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Authors: Nopadol Burananuth, Tawatpupisit Pattaradapa

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The objective of this research is to study opinion of staff responsible for Quality Assurance. Research sample is 50 staff at Suan Sunandha Rajabhat University related to Quality Assurance works from each faculty and organization within the university. Data were analyzed using the computer program. The statistics used in data analysis were frequency, percentage, mean and standard deviation. The results reveal that most of the respondents were female, 92%, aged between 31-40 years, 44%. Most of them have been working on Quality Assurance for 1-3 years, 44%. The staff opinion survey showed that the operation received the highest score. In terms of Planning, committee appointment and job descriptions received the highest mean score. For Checking, acknowledging the results and reviewing quality in education received the highest mean score. For Acting, participating in the meeting in order to revise approach to Quality Assurance received the highest mean score. For Doing, planning an internal quality assurance by assigning period, budget and responsibilities received the highest mean score.

Keywords: education quality assurance, administration, staff, Suan Sunandha Rajabhat University

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Authors: Paul Saah, Charles Mbohwa, Nelson Sizwe Madonsela

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Organisations that want to have a competitive edge over their rivals in their industry are becoming more and more aware of the value of staff training and development programs. This conceptual study's primary goal is to determine how staff development and training affect an organization's ability to succeed. A non-empirical methodological approach was chosen because this was a conceptual study, and a thorough literature analysis was conducted to determine the contribution of staff training and development to the performance of a commercial organization. Twenty of the 100 publications about employee training and development that were obtained from Google Scholar and regarded to be more pertinent were examined for this study. The impact of employee training and development in an organization was found and documented during the analyses. According to the study's findings, some of the major advantages of staff development and training include greater productivity, the discovery of employee potential, job satisfaction, the development of skills, less supervision, a decrease in turnover and absenteeism as well as less supervision and reduction of errors and accidents. The findings show that organisations that make significant investments in the training and development of their personnel are more likely to succeed than those who do not.

Keywords: impact, employment, training and development, success, business, organization

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Authors: Christine Lassen, Elizabeth Leonard, Matthew Oliver

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The management of trauma is often complex and outcomes dependent on clinical expertise, effective teamwork, and a supported trauma system. The implementation of a statewide trauma education program should be accessible to all clinicians who manage trauma, but this can be challenging due to diverse individual needs, trauma service needs and geography. The NSW Institute of Trauma and Injury Management (ITIM) is a government funded body, responsible for coordinating and supporting the NSW Trauma System. The aim of this presentation is to describe how education initiatives have been implemented across the state. Simulation: In 2006, ITIM developed a Trauma Team Training Course - aimed to educate clinicians on the technical and non-technical skills required to manage trauma. The course is now independently coordinated by trauma services across the state at major trauma centres as well as in regional and rural hospitals. ITIM is currently in the process of re-evaluating and updating the Trauma Team Training Course to allow for the development of new resources and simulation scenarios. Trauma Education Evenings: In 2013, ITIM supported major trauma services to develop trauma education evenings which allowed the provision of free education to staff within the area health service and local area. The success of these local events expanded to regional hospitals. A total of 75 trauma education evenings have been conducted within NSW, with over 10,000 attendees. Wed-Based Resources: Recently, ITIM commenced free live streaming of the trauma education evenings which have now had over 3000 live views. The Trauma App developed in 2015 provides trauma clinicians with a centralised portal for trauma information and works on smartphones and tablets that integrate with the ITIM website. This supports pre-hospital and bedside clinical decisions and allows for trauma care to be more standardised, evidence-based, timely, and appropriate. Online e-Learning modules have been developed to assist clinicians, reduce unwarranted clinical variation and provide up to date evidence based education. The modules incorporate clinically focused education content with summative and formative assessments. Conclusion: Since 2005, ITIM has helped to facilitate the development of trauma education programs for doctors, nurses, pre-hospital and allied health clinicians. ITIM has been actively involved in more than 100 specialized trauma education programs, seminars and clinical workshops - attended by over 12,000 staff. The provision of state-wide trauma education is a challenging task requiring collaboration amongst numerous agencies working towards a common goal – to provide easily accessible trauma education.

Keywords: education, simulation, team-training, trauma

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Authors: Golyasamin Khanehzaei, Mohd. Bakri Ishak, Ahmad Makmom Hj Abdullah, Latifah Abd Manaf

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Abstract—Management of clinical waste is a critical problem worldwide. Immediate attention is required to manage the clinical waste in an appropriate way in newly developing economy country such as Malaysia. The increasing amount of clinical waste generated is resulted from rapid urbanization and growing number of private health care facilities in developing countries such as Malaysia. In order to develop a sensible clinical waste management system and improvement of the management, information on factors affecting clinical waste generation has the crucial role. This paper is the study of management characteristics of clinical waste and the level of efficiency of clinical waste management systems operating in private clinics located in Selangor, Malaysia. Are they following the proper international standards? By taking all of this in consideration the aim of this paper is to identify and discuss the current trend, current challenges and also the present opportunities among the challenges of clinical waste management in private clinics of Selangor, Malaysia. The SWOT analysis was characterized for the evaluation of strengths, weaknesses, opportunities and threats. The methodology for this study was constituted of direct observation, Informal interviews, Conducting SWOT analysis, conduction of one sustainability dimensions analysis and application. The results show that clinical waste management in private clinics is far from an ideal model.

Keywords: clinical waste, SWOT analysis, Selangor, Malaysia

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Authors: Thizwilondi Madzaga, Jabu Tsakani Mabunda, Takalani Tshitangano

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Hypertension is a global public health problem. In most cases, hypertension individuals are not aware of their condition, and they only detected it accidentally during public awareness programmes. The aim of the study was to determine the prevalence, awareness and control of hypertension among University of Venda academic staff. UNIVEN is situated in Thohoyandou, South Africa. A cross-sectional study was conducted to determine the prevalence, awareness and control of hypertension among University of Venda academic staff. Slovin’s formula was used to randomly select 179 academic staff (male=104 and female=75). WHO stepwise Questionnaire version 23.0 was used to get information on demographic information. Blood pressure was measured twice after five minutes rest using electronic blood pressure monitor. In this study, hypertension referred to self-reported to be on hypertension medication or having blood pressure equal or exceeding 140 over 90 mmHg. Statistical Package of Social Sciences version 23.0 was used to analyse data. Prevalence of hypertension was 20% and 46% prehypertension. Only 34% had a normal blood pressure. About 34% were not sure of their current blood pressure status (within 12 months). About 10% of the total respondents had been previously diagnosed with hypertension and half of them who were hypertensive were not aware that they had it. Among those who were aware that they are hypertensive, about 90% were on treatment whereas 10% had stopped taking treatment. About 13% of those who were on treatment had controlled blood pressure. There is a need for health education programmes to increase hypertension awareness.

Keywords: academic staff, awareness, control, hypertension, prevalence

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Authors: Myriam Rousseau, Suzie McKinnon, Mathieu Mireault, Anaïs V. Berthiaume, Marie-Hélène Poulin, Jacinthe Bourassa, Louis-Simon Maltais

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The increasing presence of young people with autism is forcing schools to adapt to this new situation and to offer services that meet the needs of this clientele. However, school staff often feels unqualified to support these students, lacking the preparation, skills and training to meet their needs. Continuing education for these staff is therefore essential to ensure that they can meet the needs of these students. As a result, the Government of Quebec has developed a bilingual (French and English) online training on autism specific to the needs of school staff. Therefore, adequate training for all school staff is likely to provide quality learning opportunities for these students. The research project focuses on the participants' appreciation, contributions, and social validity of the training. More specifically, it aims to: 1) evaluate the knowledge and self-efficacy of the participants, 2) evaluate the social validity and 3) document the evaluation of the ergonomics of the platform hosting the training. The evaluation carried out as part of this descriptive study uses a quantitative method. Data are collected using questionnaires completed online. The analysis of preliminary data reveals that participants' knowledge of autism and their sense of self-efficacy increased significantly. They value the training positively and consider it to be acceptable, appropriate, and suitable. The participants find it important for school staff to take this training. Almost all the items measuring the ergonomics of the platform have averages above 4.57/5. In general, the study shows that the training allows participating of the trainee school staff to improve their knowledge of autism and their sense of self-efficacy with young people with autism. In addition, participants recognize that the training has good social validity and appreciate the online modality. However, these results should be interpreted with caution given the limited number of participants who completed the research project. It is therefore important to continue the research with a larger number of participants to allow an adequate and general representativeness of the social validity, the feeling of competence and the appreciation of the platform.

Keywords: autism, online training, school staff, social validity

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Authors: Hye-Kyung Kang

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Social justice is a central principle of the social work profession and education. However, scholars have long questioned the profession’s commitment to putting social justice values into practice. Clinical social work has been particularly criticized for its lack of attention to social justice and for failing to address the concerns of the oppressed. One prominent criticism of clinical social work is that it often relies on individual intervention and fails to take on system-level changes or advocacy. This concern evokes the historical macro-micro tension of the social work profession where micro (e.g., mental health counseling) and macro (e.g., policy advocacy) practices are conceptualized as separate domains, creating a false binary for social workers. One contributor to this false binary seems to be that most clinical practice models do not prepare social work students and practitioners to make a clear link between clinical practice and social justice. This paper presents a model of clinical social work practice that clearly recognizes the essential and necessary connection between social justice, advocacy, and clinical practice throughout the clinical process: engagement, assessment, intervention, and evaluation. Contemporary relational theories, critical social work frameworks, and anti-oppressive practice approaches are integrated to build a clinical social work practice model that addresses the urgent need for mental health practice that not only helps and heals the person but also challenges societal oppressions and aims to change them. The application of the model is presented through case vignettes.

Keywords: social justice, clinical social work, clinical social work model, integrative model

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Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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Authors: Narottam Puri, Gurvinder Kaur

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Background: The National Accreditation Board for Hospitals & Healthcare Providers (NABH) is India’s apex standard setting accrediting body in health care which evaluates and accredits healthcare organizations. NABH requires accredited organizations to become reaccredited every three years. It is often though that once the initial accreditation is complete, the foundation is set and reaccreditation is a much simpler process. Fortis Hospital, Shalimar Bagh, a part of the Fortis Healthcare group is a 262 bed, multi-specialty tertiary care hospital. The hospital was successfully accredited in the year 2012. On completion of its first cycle, the hospital underwent a reaccreditation assessment in the year 2015. This paper aims to gain a better understanding of the challenges that accredited hospitals face when preparing for a renewal of their accreditations. Methods: The study was conducted using a cross-sectional mixed methods approach; semi-structured interviews were conducted with senior leadership team and staff members including doctors and nurses. Documents collated by the QA team while preparing for the re-assessment like the data on quality indicators: the method of collection, analysis, trending, continual incremental improvements made over time, minutes of the meetings, amendments made to the existing policies and new policies drafted was reviewed to understand the challenges. Results: The senior leadership had a concern about the cost of accreditation and its impact on the quality of health care services considering the staff effort and time consumed it. The management was however in favor of continuing with the accreditation since it offered competitive advantage, strengthened community confidence besides better pay rates from the payors. The clinicians regarded it as an increased non-clinical workload. Doctors felt accountable within a professional framework, to themselves, the patient and family, their peers and to their profession; but not to accreditation bodies and raised concerns on how the quality indicators were measured. The departmental leaders had a positive perception of accreditation. They agreed that it ensured high standards of care and improved management of their functional areas. However, they were reluctant in sparing people for the QA activities due to staffing issues. With staff turnover, a lot of work was lost as sticky knowledge and had to be redone. Listing the continual quality improvement initiatives over the last 3 years was a challenge in itself. Conclusion: The success of any quality assurance reaccreditation program depends almost entirely on the commitment and interest of the administrators, nurses, paramedical staff, and clinicians. The leader of the Quality Movement is critical in propelling and building momentum. Leaders need to recognize skepticism and resistance and consider ways in which staff can become positively engaged. Involvement of all the functional owners is the start point towards building ownership and accountability for standards compliance. Creativity plays a very valuable role. Communication by Mail Series, WhatsApp groups, Quizzes, Events, and any and every form helps. Leaders must be able to generate interest and commitment without burdening clinical and administrative staff with an activity they neither understand nor believe in.

Keywords: NABH, reaccreditation, quality assurance, quality indicators

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper

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Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.

Keywords: patient safety, quality improvement, serious incidents, falls, clinical care

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Authors: Olatunji Sabitu Alimi

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This study investigated the extent to which administrators’ information storage, retrieval and processing capacities influence decisions on staff promotion in the Teaching Service Commissions (TESCOMs) in The South-West, Nigeria. One research question and two research hypotheses were formulated and tested respectively at 0.05 level of significance. The study used the descriptive research of the survey type. One hundred (100) staff on salary grade level 09 constituted the sample. Multi- stage, stratified and simple random sampling techniques were used to select 100 staff from the TESCOMs in The South-West, Nigeria. Two questionnaires titled Administrators’ Information Storage, Retrieval and Processing Capacities (AISRPC), and Staff Promotion Effectiveness (SPE) were used for data collection. The inventory was validated and subjected to test-re-test and reliability coefficient of r = 0.79 was obtained. The data were collected and analyzed using Pearson Product Moment Correlation coefficient and simple percentage. The study found that Administrators at TESCOM stored their information in files, hard copies, soft copies, open registry and departmentally in varying degrees while they also processed information manually and through electronics for decision making. In addition, there is a significant relationship between administrators’ information storage and retrieval capacities in the TESCOMs in South – West, Nigeria, (r cal = 0.598 > r table = 0.195). Furthermore, administrators’ information processing capacity and staff promotion effectiveness were found to be significantly related (r cal = 0.209 > r table = 0.195 at 0.05 level of significance). The study recommended that training, seminars, workshops should be organized for administrators on information management, while educational organizations should provide Information Management Technology (ICT) equipment for the administrators in the TESCOMs. The staff of TESCOM should be promoted having satisfied the promotion criteria such as spending required number of years on a grade level, a clean record of service and vacancy.

Keywords: information processing capacity, staff promotion effectiveness, teaching service commission, Nigeria

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Authors: Nanyombi Lubimbi, Josette Niyokindi

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Background: As in many other developing countries in Africa, Rwanda suffers from a chronic shortage of skilled Health Care professionals including Clinical Instructors. This shortage negatively affects the clinical instruction quality therefore impacting student-learning outcomes. Due to poor clinical supervision, it is often noted that students have no structure or consistent guidance in their learning process. The Clinical Educators and the Rwandan counterparts identified the need to create a favorable environment for learning. Description: During orientation the expectations of the student learning process, collaboration of the clinical instructors with the nurses and Clinical Educators is outlined. The ward managers facilitate structured learning by helping the students identify a maximum of two patients using the school’s objectives to guide the appropriate selection of patients. Throughout the day, Clinical Educators with collaboration of Clinical Instructors when present conduct an ongoing assessment of learning and provide feedback to the students. Post-conference is provided once or twice a week to practice critical thinking skills of patient cases that they have been taking care of during the day. Lessons Learned: The students are found to be more confident with knowledge and skills gained during rotations. Clinical facility evaluations completed by students at the end of their rotations highlight the student’s satisfaction and recommendation for continuation of structured learning. Conclusion: Based on the satisfaction of both students and Clinical Instructors, we have identified need for structured learning during clinical rotations. We acknowledge that more evidence-based practice is necessary to effectively address the needs of nursing and midwifery students throughout the country.

Keywords: Rwanda, clinical rotation, structured learning, critical thinking skills, post-conference

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