Search results for: care home management

Authors: Pavel Svoboda, Oldřich Müller

Abstract:

The paper contains a screening of the opinions of helping professional workers working in a home for seniors with individuals with neurocognitive disorders and compares them with the opinions of a younger generation of students who are just preparing for this work. The authors carried out a comparative questionnaire survey with both target groups, focusing on the analysis and comparison of possible differences in their knowledge in the field of care for elderly people with neurocognitive disorders. Specifically, they focused on knowledge and experience with approaches, methods and tools applicable within the framework of music therapy interventions, as they are understood in practice in comparison with the theoretical knowledge of secondary school students focused on social work. The questionnaire was mainly aimed at assessing the knowledge of the possibilities of effective memory stimulation of the elderly and their communication skills using the means of music. The conducted investigation was based on the research of studies dealing with so-called non-pharmacological approaches to the given clientele; for professional caregivers, it followed music therapy lessons, which the authors regularly implemented from the beginning of 2022. Its results will, among other things, serve as the basis for an upcoming study with a scoping design review.

Keywords: neurocognitive disorders, seniors, music therapy intervention, melody, rhythm, text, memory stimulation, communication skills

Procedia PDF Downloads 69

Authors: Sharlene Fernandes

Abstract:

Literature has shed light on the challenges of mothers of children with ASD, one of which involves sacrificing their professional jobs to fulfill the demands of their caregiving roles. However, the voices of the mothers who pursue employment along with caregiving roles have been overlooked. This study aimed to address this issue by exploring the narratives of Employed Mothers of Children with Autism Spectrum Disorder using the Narrative approach to inquiry. Through the view of Feminist Standpoint Theory, this study attempted to understand the role of sociocultural and systemic factors in shaping the lives of mothers. By employing the theoretical lens of Ethics of Care, this study explored how mothers balance care with their employment responsibilities, which are expected to be balanced seamlessly. Through narrative interviews, the study addressed the mothers' narratives on navigating work and caregiving, delving into their interpretations regarding expectations of care. The study gained valuable insights into the nuanced dynamics of employment, caregiving, and gender roles among mothers of children with Autism in the Indian context, implicating the urgent need for organizational policies, enhanced support systems, better quality therapeutic services, and inclusive school developments.

Keywords: Autism Spectrum Disorder, Caregivers, Employed Mothers, India, Narratives

Procedia PDF Downloads 7

Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

Abstract:

Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

Procedia PDF Downloads 187

Authors: Nishimwe Clemence, Mchunu Gugu, Mukamusoni Dariya

Abstract:

Background: Community health workers and extension workers can play an important role in supporting families to adopt health practices, encourage delivery in a health care facility, and ensure time referral of mothers and newborns if needed. Saving the lives of neonates should, therefore, be a significant health outcome in any maternal and newborn health program that is being implemented. Furthermore, about half of a million mothers die from pregnancy-related causes. Maternal and newborn deaths related to the period of postnatal care are neglected. Some authors emphasized that in developing countries, newborn mortality rates have been reduced much more slowly because of the lack of many necessary facility-based and outreach service. The aim of this review was to critically analyze the implementation and integration process of the maternal and newborn health care program by maternal community health workers, into the health care system, in Africa. Furthermore, it aims to reduce maternal and newborn mortality. We addressed the following review question: (1) what process is involved in the implementation and integration of the maternal and newborn health care program by maternal community health workers during antenatal, delivery and postnatal care into health system care in Africa? Methods: The database searched was from Health Source: Nursing/Academic Edition through academic search complete via EBSCO Host. An iterative approach was used to go through Google scholarly papers. The reviewers considered adapted Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance, and the Mixed Methods Appraisal Tool (MMAT) was used. Synthesis method in integrative review following elements of noting patterns and themes, seeing plausibility, clustering, counting, making contrasts and comparisons, discerning commons and unusual patterns, subsuming particulars into general, noting relations between variability, finding intervening factors and building a logical chain of evidence, using data–based convergent synthesis design. Results: From the seventeen of studies included, results focused on three dimensions inspired by the literature on antenatal, delivery, and postnatal interventions. From this, further conceptual framework was elaborated. The conceptual framework process of implementation and integration of maternal and newborn health care program by maternal community health workers was elaborated in order to ensure the sustainability of community based intervention. Conclusions: the review revealed that the implementation and integration of maternal and newborn health care program require planning. We call upon governments, non-government organizations, the global health community, all stakeholders including policy makers, program managers, evaluators, educators, and providers to be involved in implementation and integration of maternal and newborn health program in updated policy and community-based intervention. Furthermore, emphasis should be placed on competence, responsibility, and accountability of maternal community health workers, their training and payment, collaboration with health professionals in health facilities, and reinforcement of outreach service. However, the review was limited in focus to the African context, where the process of maternal and newborn health care program has been poorly implemented.

Keywords: Africa, implementation of integration, maternal, newborn

Procedia PDF Downloads 162

Authors: Yosi Maria Wijaya, Florisma Arista Riti Tegu

Abstract:

Background: Hypertension in pregnancy can be prevented by controlling the lifestyle. However, the majority of research on this topic has been conducted on lifestyle in women with normal pregnancy. Few studies of lifestyle have focused on Indonesian pregnant women with hypertension. Aim: The purpose of this study is to determine the association of demographic characteristics and the lifestyle of pregnant women who have hypertension. Methods: In this cross-sectional study, 76 women with hypertension during pregnancy were recruited from primary health care, West Java, Indonesia. Inclusion criteria were gestational age ≥ 28 weeks with the blood pressure systole ≥ 140 mmHg and diastole ≥ 90 mmHg. Data were collected using two instruments: demographic data and Health Promoting Life Style Profile (HPLP II). Data were analyzed with descriptive statistic and linear regression analysis. Results: The majority of participants were married, mean age was 27.96 years old (SD=6.77) with the mean of gestational age 33.21 (SD=3.49), most of them unemployed (94.7%) and more than a half participants have an education less than twelve years (59.2%). The total score of lifestyle was 2.44 (SD=0.34), more than a half participants experience unhealthy lifestyle (59.2%). Lifestyle was predicted by income, education years, occupation, and access to health care services, accounting for 20.8% of the total variance. Conclusion: Pregnant women with hypertension with low income, low level of education, non-occupational and hard to access health care services were related to unhealthy lifestyle. Understanding the lifestyle and associated factors contributes to health care providers ability to design effective interventions intended to improve healthy lifestyle among pregnant women with hypertension.

Keywords: demographic characteristics, hypertension, lifestyle, pregnancy

Procedia PDF Downloads 191

Authors: M. R. Akshaya, Veena Rao

Abstract:

Pet population in India is increasing phenomenally owing to the changes in urban lifestyle with increasing number of single professionals, single parents, delayed parenthood etc. The animal companionship as a means of reducing stress levels, deriving emotional support, and unconditional love provided by dogs are a few reasons attributed for increasing pet ownership. The consequence is the booming of the pet care products and dog care centers catering to the different requirements of rearing the pets. Dog care centers quite popular in tier 1 metros of India cater to the requirement of the dog owners providing space for the dogs in absence of the owner. However, it is often reported that the absence of the owner leads to destructive and exploratory behavior issues; the main being the anxiety disorders. In the above context, it becomes imperative for a designer to design dog boarding centers that help in reducing the separation anxiety in dogs keeping in mind the different interior design parameters. An exploratory research with focus group discussion is employed involving a group of dog owners, behaviorists, proprietors of day care as well as boarding centers, and veterinarians to understand their perception on the significance of different interior parameters of color, texture, ventilation, aroma therapy and acoustics as a means of reducing the stress levels in dogs sent to the boarding centers. The data collected is organized as thematic networks thus enabling the listing of the interior design parameters that needs to be considered in designing dog boarding centers. 

Keywords: behavioral response, design parameters, dog boarding centers, interior environment

Procedia PDF Downloads 204

Authors: Naphaporn Sapsopha

Abstract:

Aging population has been growing rapidly in Thailand due to several factors – namely, the declining size of the average Thai family, changing family structure, higher survival rates of women, and job migration patterns – there are fewer working-age citizens who are able to care for and support their aging family members. When a family can no longer provide for their elders, the responsibility shifts to the government. Many non-profit institutional care facilities for older adults have already been established, but having such institutions are not enough. In addition to the provisions that a reliable shelter can provide, older adults also need efficient social services, physical wellness, and mental health, all of which are crucial for successful aging. Yet, to date, there is no consensus or a well-accepted definition of what constitutes successful aging. The issue is further complicated by cultural expectations, and the gendered experience of the older adults. These issues need to be better understood to promote effective care and wellness. This qualitative research investigates the relationship between institutional care and successful aging among the institutionalized Thai older adults at a non-profit facility in Bangkok, Thailand. Specifically, it examines: a) How do institutionalized older adults define successful aging?, b) What factors do they believe contribute to successful aging?, and c) Do their beliefs vary by gender? Data was collected using a phenomenological research approach that included focus groups and in-depth interviews using open-ended questions, conducted on 10 institutionalized older adults (5 men and 5 women) ages 60 or over. Interview transcripts were coded and analyzed using grounded theory methodology. The participants aged between 70-91 years old, and they varied in terms of gender, education, occupation, and life background. The results revealed that Thai institutionalized older adults viewed successful aging as a result of multiple interrelated factors: maintaining physical health, good mental and cognitive abilities. Remarkably, the participants identified as successful aging include independence for self-care and financial support, adhering to moral principles and religious practice, seeing the success of their loved ones, and making social contributions to their community. In addition, three primary themes were identified as a coping strategy to age successfully: self-acceptance by being sufficient and satisfied with all aspects of life, preparedness and adaptation for every stage of life, and self-esteem by maintaining their self. These beliefs are shared across gender and age differences. However, participants highlighted the importance of the interrelationship among these attributes similar to the need for a secure environment, the thoughtfulness and social support of institutional care in order to maintain positive attitude and well-being. With highly increased Thai aging population, many of these older adults will find themselves living in the institutional care; therefore, it is important to intensively understand how older adults viewed successful aging, what constituted successful aging and what could be done to promote it. Interventions to enhance successful aging may include meaningful practice and along with an effective coping strategy in order to lead a better quality of life those living in institutional care.

Keywords: institutional care, older adults, self-acceptant, successful aging

Procedia PDF Downloads 311

Authors: Evelyn Castle, Adam Thompson

Abstract:

Background: In 2013, the Kano State Primary Health Care Management Board redesigned its Routine immunization supply chain from diffused pull to direct delivery push. It addressed issues around stockouts and reduced time spent by health facility staff collecting, and reporting on vaccine usage. The health care board sought the help of a 3PL for twice-monthly deliveries from its cold store to 484 facilities across 44 local governments. eHA’s Health Delivery Systems group formed a 3PL to serve 326 of these new facilities in partnership with the State. We focused on designing and implementing a technology system throughout. Basic methodologies: GIS Mapping: - Planning the delivery of vaccines to hundreds of health facilities requires detailed route planning for delivery vehicles. Mapping the road networks across Kano and Bauchi with a custom routing tool provided information for the optimization of deliveries. Reducing the number of kilometers driven each round by 20%, - reducing cost and delivery time. Direct Delivery Information System: - Vaccine Direct Deliveries are facilitated through pre-round planning (driven by health facility database, extensive GIS, and inventory workflow rules), manager and driver control panel customizing delivery routines and reporting, progress dashboard, schedules/routes, packing lists, delivery reports, and driver data collection applications. Move: Last Mile Logistics Management System: - MOVE has improved vaccine supply information management to be timely, accurate and actionable. Provides stock management workflow support, alerts management for cold chain exceptions/stock outs, and on-device analytics for health and supply chain staff. Software was built to be offline-first with user-validated interface and experience. Deployed to hundreds of vaccine storage site the improved information tools helps facilitate the process of system redesign and change management. Findings: - Stock-outs reduced from 90% to 33% - Redesigned current health systems and managing vaccine supply for 68% of Kano’s wards. - Near real time reporting and data availability to track stock. - Paperwork burdens of health staff have been dramatically reduced. - Medicine available when the community needs it. - Consistent vaccination dates for children under one to prevent polio, yellow fever, tetanus. - Higher immunization rates = Lower infection rates. - Hundreds of millions of Naira worth of vaccines successfully transported. - Fortnightly service to 326 facilities in 326 wards across 30 Local Government areas. - 6,031 cumulative deliveries. - Over 3.44 million doses transported. - Minimum travel distance covered in a round of delivery is 2000 kms & maximum of 6297 kms. - 153,409 kms travelled by 6 drivers. - 500 facilities in 326 wards. - Data captured and synchronized for the first time. - Data driven decision making now possible. Conclusion: eHA’s Vaccine Direct delivery has met challenges in Kano and Bauchi State and provided a reliable delivery service of vaccinations that ensure t health facilities can run vaccination clinics for children under one. eHA uses innovative technology that delivers vaccines from Northern Nigerian zonal stores straight to healthcare facilities. Helped healthcare workers spend less time managing supplies and more time delivering care, and will be rolled out nationally across Nigeria.

Keywords: direct delivery information system, health delivery system, GIS mapping, Northern Nigeria, vaccines

Procedia PDF Downloads 373

Authors: Muhammad Abba Jallo, Fred Fudah Moveh

Abstract:

This study addresses the challenges faced by Nigerian law enforcement agencies due to the lack of an integrated crime management system. While various agencies use ICT-based systems, the absence of interoperability creates barriers to effective collaboration and information sharing. The research proposes the development of an Interagency Crime Management System (ICMS), which integrates the Crime Management Systems (CMS) of different agencies through an Application Program Interface (API). The system is designed to allow all law enforcement agencies to input data using a standardized format, improving crime tracking, reporting, and management across Nigeria. This paper details the design and implementation process, highlighting the benefits of enhanced collaboration for crime management.

Keywords: crime management, Nigeria, law enforcement, ICT

Procedia PDF Downloads 19

Authors: J. A. Batsis, G. G. Boateng, L. M. Seo, C. L. Petersen, K. L. Fortuna, E. V. Wechsler, R. J. Peterson, S. B. Cook, D. Pidgeon, R. S. Dokko, R. J. Halter, D. F. Kotz

Abstract:

Resistance exercise bands are a core component of any physical activity strengthening program. Strength training can mitigate the development of sarcopenia, the loss of muscle mass or strength and function with aging. Yet, the adherence of such behavioral exercise strategies in a home-based setting are fraught with issues of monitoring and compliance. Our group developed a Bluetooth-enabled resistance exercise band capable of transmitting data to an open-source platform. In this work, we developed an application to capture this information in real-time, and conducted three usability studies in two mixed-aged groups of participants (n=6 each) and a group of older adults with obesity participating in a weight-loss intervention (n=20). The system was favorable, acceptable and provided iterative information that could assist in future deployment on ubiquitous platforms. Our formative work provides the foundation to deliver home-based monitoring interventions in a high-risk, older adult population.

Keywords: application, mHealth, older adult, resistance exercise band, sarcopenia

Procedia PDF Downloads 174

Authors: Erin C. Rodenburg, Jennifer McWhirter, Andrew Papadopoulos

Abstract:

Support workers for adults with developmental disabilities promote the care and wellbeing of a historically underserved population. Poor employment training and low work satisfaction for these disability support workers are linked to low productivity, poor quality of care, turnover, and intention to leave employment. Therefore, to improve the lives of those within disability support homes, both client and caregiver, it is vital to determine where improvements to training and support for those providing direct care can be made. The current study aims to explore disability support worker’s perceptions of the training received in their employment at the residential homes, how it prepared them for their role, and where there is room for improvement with the aim of developing recommendations for an improved training experience. Responses were collected from 85 disability support workers across 40 Ontario group homes. Findings suggest most disability support workers within the 40 support homes feel adequately trained in their responsibilities of employment. For those who did not feel adequately trained, the main issues expressed were a lack of standardization in training, a need for more continuous training, and a move away from trial and error in performing tasks to support clients with developmental disabilities.

Keywords: developmental disabilities, disability workers, support homes, training

Procedia PDF Downloads 188

Authors: Prateep Wajeetongratana

Abstract:

The objectives of the research were to examine that how management accounting techniques were perceived and used by companies listed on the stock exchange and to investigate similarities or differences of management accounting practices between companies listed on the stock exchange and Thai SMEs. Descriptive and inferential statistics were employed. The finding found that almost all of the companies used traditional management accounting techniques more than advanced management accounting techniques. Four management accounting techniques having no significant association with business characteristic were standard costing, job order costing, process costing. The barriers that Thai SMEs encountered were a lack of proper accounting system and the insufficient knowledge in management accounting of the accountants. The comparison results revealed that both companies listed on the stock exchange and Thai SMEs used traditional management accounting techniques more than advanced techniques.

Keywords: companies listed on the stock exchange, financial budget, management accounting, operating budget

Procedia PDF Downloads 383

Authors: A. Gonzalez Aguna, J. M. Santamaria Garcia, J. L. Gomez Gonzalez, R. Barchino Plata, M. Fernandez Batalla, S. Herrero Jaen

Abstract:

Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.

Keywords: care, learning, nursing, technology

Procedia PDF Downloads 136

Authors: Fayez Hanna, Viet Tran

Abstract:

A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

Procedia PDF Downloads 102

Authors: Kanchan Negi

Abstract:

Background: Modern work culture has driven demands for people to work long hours and weekends and take work to home at times. Research on the health effects of these exhaustive temporal work patterns is scant or contradictory. This study examines the relationship between work patterns and well-being (including happiness) in a sample of working women. Method: Primary data of 360 currently married women working in the education, health, banking and IT sector in Delhi, India, were analysed. Logistic regression was used to estimate physical and psychological well-being and happiness across work characteristics. Results: Relative to 35–40 hours/week, working longer related to poor well-being (ß=0.75, 95% CI 0.12 to 1.39). Compared with not working weekends, working most or all weekends is related to poor physical (ß=0.34, 95% CI 0.08 to 0.61) and psychological well-being (ß=0.50, 95% CI 0.20 to 0.79). Rigid work patterns (ß=0.17, 95% CI −0.09 to 0.42) are also related to poor well-being. Conclusion: Decreased well-being and unhappiness are significantly linked to strenuous and rigid work patterns, suggesting that modern work culture may contribute to poor well-being. Flexible timings, compensatory holidays, work-from-home, and daycare facilities for young ones must be welcomed by companies to ease the dual burden of homemakers and career makers.

Keywords: happiness, well-being, work pattern, working women

Procedia PDF Downloads 183

Authors: Gunmala Suri

Abstract:

The purpose of this study was to investigate the relationship between various dimensions of Knowledge Management and Learning Organizations. On the basis of the dimensions of Learning Organization, Hypothesis were formulated. Knowledge Management (KM) is taken as the independent variable and Learning Organization (LO) as a dependent variable. KM had 5 dimensions and LO had 7. For this study, a total of 92 participants took part and answered the questionnaire. The respondents were selected using Judgemental and Snowball sampling. The respondents were from SMEs in and around Chandigarh. SPSS was used to for the data analysis purposes. The results showed that the dimensions of KM had a positive influence on the dimensions of LO. The hypothesis were accepted.

Keywords: knowledge management leadership, knowledge management, learning organization, knowledge management culture

Procedia PDF Downloads 418

Authors: John Olayinka Atoyebi

Abstract:

Developing countries like Nigeria are facing myriad problems, ranging from economic challenges, lack of no jobs, food insecurity, malnutrition, and poverty. However, tackling some of these menaces is not just a trivial issue neither do some of them require rocket science to fix, but rather the understanding of every individual citizen recognizing their respective roles that they have to play in making the country better, rather than putting all the blames on the Government. Tackling nutrition and food insecurity is a complex problem, but this work examines what an individual can do to improve nutrient consumption. Leafy indigenous vegetables can be termed as functional foods since they are very rich in nutrients, phytochemicals and other beneficial compounds to the body system. These functional foods are the class that provides necessary health benefits beyond basic nutrition. Usually functional foods often contain bioactive compounds, which help the body through the prevention and management of various diseases, as well as improving the overall health of human beings. The analysis carried out on some Nigerian leafy indigenous vegetables in home grown setting revealed, for example, the potential use of Iron (Fe) amount of 318.15ppm in Basella alba (red species) and that of Telfaria Occidentalis (Ugu) with 261.22ppm as being useful to stimulate heme, a necessary precursor and protein in the formation of blood in human being. Moreso, Virnonia amygdalina (ewuro) and water leaf possess anti-bacterial and anti-diabetic properties. They also provide digestive health benefits and support to the body system, including anti-inflammatory properties. Also, medicinal plant like Morinda citrifolia (Noni), which had been found to possess anti-cancer properties, has a Vitamin C amount of 528.85 mg/100g and a total carotenoids amount of 85.50 µg/g. However, despite all these results and potential utilization of these and other indigenous vegetables in Nigeria, there is a gross unawareness and/or non-cognizance of their utilization potentials, as some home garden lacks understanding of the immense nutrition benefits, thus hindering some of the populace to make proper use of these vegetables to enhance their health.

Keywords: developing countries, optimising, leafy vegetables, functional foods

Procedia PDF Downloads 5

Authors: Maria A. Murtiati, Ancella A. Hermawan

Abstract:

The objective of this study is to examine whether the firm’s eligibility to get a bank loan is influenced by earnings management. The earnings management is distinguished between accruals and real earnings management. Hypothesis testing is carried out with logistic regression model using sample of 285 companies listed at Indonesian Stock Exchange in 2010. The result provides evidence that a greater magnitude in accruals earnings management increases the firm’s probability to be eligible to get bank loan. In contrast, real earnings management through abnormal cash flow and abnormal discretionary expenses decrease firm’s probability to be eligible to get bank loan, while real management through abnormal production cost increases such probability. The result of this study suggests that if the earnings management is assumed to be opportunistic purpose, the accruals based earnings management can distort the banks credit analysis using financial statements. Real earnings management has more impact on the cash flows, and banks are very concerned on the firm’s cash flow ability. Therefore, this study indicates that banks are more able to detect real earnings management, except abnormal production cost in real earning management.

Keywords: discretionary accruals, real earning management, bank loan, credit worthiness

Procedia PDF Downloads 346

Authors: Fahreza, Yudhi Herliansyah, Harnovinsah

Abstract:

This study aims to examine how management compensation and auditor reputation effect on corporate tax management in banking using a sample banking companies listed in Indonesia Stock Exchange. At first, this study examines how the influence of management compensation on the implementation of tax management that may be made by management in order to improve the performance of the company. Second, this study also examines the effect of auditor reputation conducting audit on the implementation of the tax management. The population used in this study is the banking companies listed in Indonesia Stock Exchange. The method used was purposive sampling because the samples of this study have certain criteria that are tailored to the purpose of the study. Based on purposive sampling method, the number of samples in this study is 28 samples. Hypothesis tested using multiple regression analysis. The results of this study indicate that on the 5 % significance level, management compensation significantly influenced tax management as measured using the proxy book tax gap. Other result is management compensation does not significantly affect the tax management that measured using a proxy GAAP effective tax rate. In addition the auditor's reputation does significantly influence tax management as measured using the proxy book tax gap and GAAP effective tax rate.

Keywords: tax management, management compensation, auditor reputation, corporate characteristic

Procedia PDF Downloads 300

Authors: Gianluca Castelnuovo, Gian Mauro Manzoni, Giada Pietrabissa, Stefania Corti, Emanuele Giusti, Roberto Cattivelli, Enrico Molinari, Susan Simpson

Abstract:

Obesity is currently an important public health problem of epidemic proportions (globesity). Moreover Binge Eating Disorder (BED) is typically connected with obesity, even if not occurring exclusively in conjunction with overweight conditions. Typically obesity with BED requires a longer term treatment in comparison with simple obesity. Rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation, due to the growing costs of a limited inpatient approach. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach. The new m health (m-health, mobile health) paradigm, defined as clinical practices supported by up to date mobile communication devices, could increase compliance- engagement and contribute to a significant cost reduction in BED and obesity rehabilitation. Five psychological components need to be considered for successful m Health-based obesity rehabilitation in order to facilitate weight-loss.1) Self-monitoring. Portable body monitors, pedometers and smartphones are mobile and, therefore, can be easily used, resulting in continuous self-monitoring. 2) Counselor feedback and communication. A functional approach is to provide online weight-loss interventions with brief weekly or monthly counselor or psychologist visits. 3) Social support. A group treatment format is typically preferred for behavioral weight-loss interventions. 4) Structured program. Technology-based weight-loss programs incorporate principles of behavior therapy and change with structured weekly protocolos including nutrition, exercise, stimulus control, self-regulation strategies, goal-setting. 5) Individually tailored program. Interventions specifically designed around individual’s goals typically record higher rates of adherence and weight loss. Opportunities and limitations of m health approach in clinical psychology for obesity and BED are discussed, taking into account future research directions in this promising area.

Keywords: obesity, rehabilitation, out-patient, new technologies, tele medicine, tele care, m health, clinical psychology, psychotherapy, chronic care management

Procedia PDF Downloads 473

Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

Abstract:

Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

Procedia PDF Downloads 271

Authors: Sunidhi Sood, Drashti Narendrakumar Shah, Aakarsh Sharma, Nirali Harsh Panchal, Maria Karizhenskaia

Abstract:

Cancer is a global health concern, causing a significant number of deaths, with chemotherapy being a standard treatment method. However, chemotherapy often induces side effects that profoundly impact the physical and emotional well-being of patients, lowering their overall quality of life (QoL). This research aims to investigate the potential of music and art therapy as holistic adjunctive therapy for cancer patients undergoing chemotherapy, offering non-pharmacological support. This is achieved through a comprehensive review of existing literature with a focus on the following themes, including stress and anxiety alleviation, emotional expression and coping skill development, transformative changes, and pain management with mood upliftment. A systematic search was conducted using Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 2014 to 2023. The review solely incorporated studies focusing on the impact of music and art therapy on the health and overall well-being of cancer patients undergoing chemotherapy in North America. The findings from 16 studies involving pediatric oncology patients, females affected by breast cancer, and general oncology patients show that music and art therapies significantly reduce anxiety (standardized mean difference: -1.10) and improve perceived stress (median change: -4.0) and overall quality of life in cancer patients undergoing chemotherapy. Furthermore, music therapy has demonstrated the potential to decrease anxiety, depression, and pain during infusion treatments (average changes in resilience scale: 3.4 and 4.83 for instrumental and vocal music therapy, respectively). This data calls for consideration of the integration of music and art therapy into supportive care programs for cancer patients undergoing chemotherapy. Moreover, it provides guidance to healthcare professionals and policymakers, facilitating the development of patient-centered strategies for cancer care in Canada. Further research is needed in collaboration with qualified therapists to examine its applicability and explore and evaluate patients' perceptions and expectations in order to optimize the therapeutic benefits and overall patient experience. In conclusion, integrating music and art therapy in cancer care promises to substantially enhance the well-being and psychosocial state of patients undergoing chemotherapy. However, due to the small population size considered in existing studies, further research is needed to bridge the knowledge gap and ensure a comprehensive, patient-centered approach, ultimately enhancing the quality of life (QoL) for individuals facing the challenges of cancer treatment.

Keywords: anxiety, cancer, chemotherapy, depression, music and art therapy, pain management, quality of life

Procedia PDF Downloads 74

Authors: Fatma Refaat Ahmed, Sally Mohamed Farghaly

Abstract:

Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

Procedia PDF Downloads 68

Authors: Asfa Hussain, Chee Tang, Mien Nguyen

Abstract:

Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

Procedia PDF Downloads 176

Authors: Rigas Dimakopoulos, Marianna Papadopoulou, Roser Pons

Abstract:

Background: Participation in family, recreational activities and self-care is an integral part of health. It is also the main outcome of rehabilitation services for children and adolescents with motor disabilities. There are currently no tools in Greek to assess participation in young children. Purpose: To culturally adapt and validate the Greek version of the Child Engagement in Daily Living (CEDL). Method: The CEDL was cross-culturally translated into Greek using forward-backward translation, review by the expert committee, pretest application and final review. Internal consistency was evaluated using the Cronbach alpha and test-retest reliability using the intra-class correlation coefficient (ICC). Parents of children aged 18 months to 5 years and with motor disabilities were recruited. Participants completed the CEDL and the children’s gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Results: Eighty-three children were included, GMFCS I-V. Mean ± standard deviation of the CEDL domains “frequency of participation” “enjoyment of participation” and “self-care” were 58.4±14.0, 3.8±1.0 and 49.9±24, respectively. Internal consistency of all domains was high; Cronbach alpha for “frequency of participation” was 0.83, for “enjoyment of participation” was 0.76 and for “self-care” was 0.92. Test-retest reliability (ICC) was excellent for the “self-care” (0.95) and good for “frequency of participation” and “enjoyment of participation” domains (0.90 and 0.88, respectively). Conclusion: The Greek CEDL has good reliability. It can be used to evaluate participation in Greek young children with motor disabilities GMFCS levels I-V.

Keywords: participation, child, disabilities, child engagement in daily living

Procedia PDF Downloads 175

Authors: Faris Alghamdi

Abstract:

Identifying which conflict management styles organizational members prefer, and what variables influence these selections, is an essential component of organizational conflict management as well as human resource management, particularly in training and development strategies. This study aims to examine the relationship between work experience and preferred conflict management styles. Utilizing the Rahim Organizational Conflict Inventory- II Form C, data were collected from 109 full-time employees of various organizations in the Eastern province of Saudi Arabia. The Pearson’s correlation coefficient analysis showed a statistically significant relationship between the integrating conflict management style and the length of work experience. Nevertheless, this relationship was negative, not positive as hypothesized.

Keywords: conflict management style, organizational members, work experience

Procedia PDF Downloads 409

Authors: Sedigheh Salemi, Mahnaz Sanjari, Maryam Aalaa, Mohammad Mirzabeigi

Abstract:

Clinical governance is the framework within which the health service provider is required to ongoing accountability and improvement of the quality of their services. This cross-sectional study was conducted in 661 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 24 questions in which 4 questions focused on clinical governance defining from the nurses' perspective. The reliability was evaluated by Cronbach's alpha (α=0/83). Statistical analyzes were performed, using SPSS version 16. Approximately 40% of nurses correctly answered that clinical governance is not "system of punishment and rewards for the staff". The most nurses believed that "clinical efficacy" is one of the main components of clinical governance. A few of nurses correctly responded that "Evidence Based Practice" and "management" is not part of clinical governance. The small number of nurses correctly answered that the "maintenance of patient records" and "to recognize the adverse effects" is not the role of nurse in clinical governance. Most "do not know" answer was to the "maintenance of patient records". The most nurses unanimously believed that the implementation of clinical governance led to "promoting the quality of care". About a third of nurses correctly stated that the implementation of clinical governance will not lead to "an increase in salaries and benefits of the medical team". As a member of the health team, nurses are responsible in terms of participation in quality improvement and it is necessary to create an environment in which clinical care will flourish and serve to preserve the high standards.

Keywords: clinical governance, nurses, salary, health team

Procedia PDF Downloads 430

Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

Abstract:

Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

Procedia PDF Downloads 62

Authors: Molly Parker

Abstract:

Unintended pregnancy rates in Australia are amongst the highest in the developed world. Women with Substance Use Disorder often have riskier sexual behavior with nil contraceptive use and face disproportionately higher unintended pregnancies and Sexually Transmitted Infections, alongside Substance Use in Pregnancy (SUP) climbing at an alarming rate. In an inner-city Drug and Alcohol (D&A) service, significant barriers to sexual and reproductive health services have been identified, aligning with research. Rapid pathways were created for women seeking D&A treatment to be referred to Sexual and Reproductive Health services for the administration of Long-acting reversible contraception (LARC) and sexual health screening. For clients attending a D&A service, this is an opportunistic time to offer sexual and reproductive health services. Collaboration and multidisciplinary team input between D&A and sexual health and reproductive services are paramount, with rapid referral pathways being identified as the main strategy to improve access to sexual and reproductive health support for this population. With this evidence, a rapid referral pathway was created for women using the D&A service to access LARC, particularly in view of fertility often returning once stable on D&A treatment. A closed-ended survey was used for D&A staff to identify gaps in reproductive health knowledge and views of referral accessibility. Results demonstrated a lack of knowledge of contraception and appropriate referral processes. A closed-ended survey for clients was created to establish the need and access to services and to quantify data. A follow-up data collection will be reviewed to access uptake and satisfaction of the intervention from clients. Sexual health screening access was also identified as a deficit, particularly concerning due to the higher rates of STIs in this cohort. A rapid referral pathway will be undergoing implementation, reducing risks of untreated STIS both pre and post-conception. Similarly, pre and post-intervention structured surveys will be used to identify client satisfaction from the pathway. Although currently in progress, the research and pathway aim to be completed by December 2023. This research and implementation of sexual and reproductive health pathways from the D&A service have significant health and well-being benefits to clients and the wider community, including possible fetal/infancy outcomes. Women now have rapid access to sexual and reproductive health services, with the aim of reducing unplanned pregnancies, poor outcomes associated with SUP, client/staff trauma from termination of pregnancy, and client/staff trauma following the assumption of care of the child due to substance use, the financial cost for out of home care as required, the poor outcomes of untreated STIs to the fetus in pregnancy and the spread of STIs in the wider community. As evidence suggests, the implementation of a streamlined referral process is required between D&A and sexual and reproductive health services and has positive feedback from both clinicians and clients in improving care.

Keywords: substance use in pregnancy, drug and alcohol, substance use disorder, sexual health, reproductive health, contraception, long-acting reversible contraception, neonatal abstinence syndrome, FASD, sexually transmitted infections, sexually transmitted infections pregnancy

Procedia PDF Downloads 64

Authors: Rebecca Greenberg, Nipa Chauhan, Rashad Rehman

Abstract:

Paternalism, in its traditional form, seems largely incompatible with Western medicine. In contrast, Family-Centred Care, a partial response to historically authoritative paternalism, carries its own challenges, particularly when operationalized as family-directed care. Specifically, in neonatology, decision-making is left entirely to Substitute Decision Makers (most commonly parents). Most models of shared decision-making employ both the parents’ and medical team’s perspectives but do not recognize the inherent asymmetry of information and experience – asking parents to act like physicians to evaluate technical data and encourage physicians to refrain from strong medical opinions and proposals. They also do not fully appreciate the difficulties in adjudicating which perspective to prioritize and, moreover, how to mitigate disagreement. Introducing a mild form of paternalism can harness the unique skillset both parents and clinicians bring to shared decision-making and ultimately work towards decision-making in the best interest of the child. The notion expressed here is that within the model of shared decision-making, mild paternalism is prioritized inasmuch as optimal care is prioritized. This mild form of paternalism is known as Beneficent Paternalism and justifies our encouragement for physicians to root down in their own medical expertise to propose treatment plans informed by medical expertise, standards of care, and the parents’ values. This does not mean that we forget that paternalism was historically justified on ‘beneficent’ grounds; however, our recommendation is that a re-integration of mild paternalism is appropriate within our current Western healthcare climate. Through illustrative examples from the NICU, this paper explores the appropriateness and merits of Beneficent Paternalism and ultimately its use in promoting family-centered care, patient’s best interests and reducing moral distress. A distinctive feature of the NICU is the fact that communication regarding a patient’s treatment is exclusively done with substitute decision-makers and not the patient, i.e., the neonate themselves. This leaves the burden of responsibility entirely on substitute decision-makers and the clinical team; the patient in the NICU does not have any prior wishes, values, or beliefs that can guide decision-making on their behalf. Therefore, the wishes, values, and beliefs of the parent become the map upon which clinical proposals are made, giving extra weight to the family’s decision-making responsibility. This leads to why Family Directed Care is common in the NICU, where shared decision-making is mandatory. However, the zone of parental discretion is not as all-encompassing as it is currently considered; there are appropriate times when the clinical team should strongly root down in medical expertise and perhaps take the lead in guiding family decision-making: this is just what it means to adopt Beneficent Paternalism.

Keywords: care, ethics, expertise, NICU, paternalism

Procedia PDF Downloads 144