Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6302

Search results for: critical care

6302 The Process of Critical Care Nursing Resilience in Workplace Adversity

Authors: Jennifer Jackson

Abstract:

Critical care nurses are at risk for burnout when confronted with sustained workplace adversity, which stems from a variety of social, structural, and environmental factors. Researchers have suggested that nurses can become resilient and overcome workplace adversity to achieve positive outcomes. The purpose of this study is to learn more about critical care nurses’ experiences with workplace adversity, and their process of becoming resilient. The research question will be: what is the process of critical care nursing resilience in workplace adversity? In-depth interviews with critical care nurses will provide the data to inductively generate the grounded theory. The resultant grounded theory will provide a framework to inform nurses and managers in developing interventions to support critical care nurses in their workplace. By enhancing nursing resilience, burnout may be avoided, and nurse satisfaction and overall quality of care may be improved.

Keywords: nursing, resilience, burnout, critical care

Procedia PDF Downloads 399
6301 Radio Frequency Identification Device Based Emergency Department Critical Care Billing: A Framework for Actionable Intelligence

Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

Abstract:

Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

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6300 Increase of Completion Rate of Nursing Care during Therapeutic Hypothermia in Critical Patients

Authors: Yi-Jiun Chou, Ying-Hsuan Li, Yi-Jung Liu, Hsin-Yu Chiang, Hsuan-Ching Wang

Abstract:

Background: Patients received therapeutic hypothermia (TH) after resuscitation from cardiac arrest are more dependent on continue and intensive nursing care. It involves many difficult steps, especially achieving target body temperature. To our best knowledge, there is no consensus or recommended standards on nursing practice of TH. Aim: The aim of this study is to increase the completion rate of nursing care at therapeutic hypothermia. Methods: We took five measures: (1) Amendment of nursing standards of therapeutic hypothermia; (2) Amendment of TH checklist items to nursing records; (3) Establishment of monitor procedure; (4) Design each period of TH care reminder cards; (5) Providing in-service training sections of TH for ICU nursing staff. Outcomes: The completion rate of nursing care at therapeutic hypothermia increased from 78.1% to 89.3%. Conclusion: The project team not only increased the completion rate but also improved patient safety and quality of care.

Keywords: therapeutic hypothermia, nursing, critical care, quality of care

Procedia PDF Downloads 306
6299 Informational Support, Anxiety and Satisfaction with Care among Family Caregivers of Patients Admitted in Critical Care Units of B.P. Koirala Institute of Health Sciences, Nepal

Authors: Rosy Chaudhary, Pushpa Parajuli

Abstract:

Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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6298 Definition, Barriers to and Facilitators of Moral Distress as Perceived by Neonatal Intensive Care Physicians

Authors: M. Deligianni, P. Voultsos, E. Tsamadou

Abstract:

Background/Introduction: Moral distress is a common occurrence for health professionals working in neonatal critical care. Despite a growing number of critically ill neonatal and pediatric patients, only a few articles related to moral distress as experienced by neonatal physicians have been published over the last years. Objectives/Aims: The aim of this study was to define and identify barriers to and facilitators of moral distress based on the perceptions and experiences of neonatal physicians working in neonatal intensive care units (NICUs). This pilot study is a part of a larger nationwide project. Methods: A multicenter qualitative descriptive study using focus group methodology was conducted. In-depth interviews lasting 45 to 60 minutes were audio-recorded. Once data were transcribed, conventional content analysis was used to develop the definition and categories, as well as to identify the barriers to and facilitators of moral distress. Results: Participants defined moral distress broadly in the context of neonatal critical care. A wide variation of definitions was displayed. The physicians' responses to moral distress included different feelings and other situations. The overarching categories that emerged from the data were patient-related, family-related, and physician-related factors. Moreover, organizational factors may constitute major facilitators of moral distress among neonatal physicians in NICUs. Note, however, that moral distress may be regarded as an essential component to caring for neonates in critical care. The present study provides further insight into the moral distress experienced by physicians working in Greek NICUs. Discussion/Conclusions: Understanding how neonatal and pediatric critical care nurses define moral distress and what contributes to its development is foundational to developing targeted strategies for mitigating the prevalence of moral distress among neonate physicians in the context of NICUs.

Keywords: critical care, moral distress, neonatal physician, neonatal intensive care unit, NICU

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6297 Emerging Issues in Early Childhood Care and Development in Nigeria

Authors: Evelyn Fabian

Abstract:

The focus of this discussion centres on the emerging issues in Early Childhood Care and development in Nigeria. Early childhood care is the bedrock of Nigeria’s educational system. However, there are critical issues that had not been addressed and it is frustrating the entire educational process. Thus, this paper will show the inter-connectedness between these issues such as poor funding, trained skillful teachers that would supervise the learning process of the kids, unconducive learning environment and lack of relevant facilities. For a clear grasp of these issues, the researcher visited 36 early childhood centres distributed across the 36 spates of Nigeria. The findings which were expressed in simple percentages revealed a near total absence or government neglect of these critical areas. The findings equally showed a misplaced priority in the government allocation of funds to early child care education and development. The study concludes that this mismatch in the training of these categories of pupils, government should expedite action in addressing these emerging issues in early childhood care and development in Nigeria.

Keywords: early childhood, ECCE, education, emerging issues

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6296 Nurse-Identified Barriers and Facilitators to Delivering End-of-Life Care in a Cardiac Intensive Care Unit: A Qualitative Study

Authors: Elena Ivany, Leanne Aitken

Abstract:

Little is known about the delivery of end-of-life care in cardiac intensive care unit (CICU) settings. The aims of this study were to highlight the nurse-identified barriers and facilitators to delivering end-of-life care in the CICU, and to identify whether any of the barriers and/or facilitators are specific to the CICU setting. This was an exploratory qualitative study utilizing semi-structured individual interviews as the data collection method and inductive thematic analysis to structure the data. Six CICU nurses took part in the study. Five key themes were identified, each theme including both barriers and facilitators. The five key themes are as follows: patient-centered care, emotional challenges, reaching concordance, nursing contribution and the surgical intensive care unit.

Keywords: end-of-life, cardiovascular disease, cardiac surgery, critical care

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6295 A Retrospective Analysis of the Use of Vancomycin by Continous Infusion in the Critical Care Setting, Edinburgh

Authors: Sonia Nemakallu, Pota Kalima

Abstract:

Introduction: Vancomycin is a glycopeptide antibiotic, commonly used to treat gram-positive bacteraemia. It has been increasingly used in the critical care setting due to an increased awareness of resistant gram positive organisms. In Edinburgh both tertiary hospitals, The Western General Hospital and The Royal Infirmary Of Edinburgh, commonly use Vancomycin for a variety of infections. Administration of Vancomyicn in these hospitals is by continuous infusion as it is thought to maintain serum concentrations easier and is a simpler monitoring system. Purpose: The aim of the study was to evaluate the efficacy and reliability in which Vancomycin is used. Material and Methods: A retrospective study, over a 6-month period from January 2014 to June 2014. 91 admissions were included, all received Vancomycin by continuous infusion during their critical care stay. Results: The number one use for Vancomycin in critical care settings was in the treatment of ventilator or hospital-acquired pneumonia. Only 3% of population had MRSA. 49% of admissions were not therapeutic on day 1 post loading dose. Of those that were therapeutic on day 1 post loading dose, 39% of admissions showed no organisms in any cultures taken, 42% had organisms sensitive to Vancomycin and 19% had only organisms resistant to Vancomycin. Those that were not therapeutic on day 1 showed similar organism sensitivities. 15% of admissions had Vancomycin levels above 25 (levels should be maintained between 15-25). An increase in creatinine was proportionally seen with an increase in Vancomycin levels. Conclusion: Within Edinburgh Vancomycin is being overused in the critical care setting with only 3% of the population having highly resistant organisms. Continuous infusion have not ruled out the complexity of maintaining therapeutic levels, with a large proportion of patients not being therapeutic on day 1. Further research is also required into the nephrotoxic effects of using higher doses of Vancomycin.

Keywords: Vancomycin, continuous infusion, multi resistant organisms, sepsis, renal toxicity

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6294 Perspective of Community Health Workers on The Sustainability of Primary Health Care

Authors: Dan Richard D. Fernandez

Abstract:

This study determined the perspectives of community health workers’ perspectives in the sustainability of primary health care. Eight community health workers, two community officials and a rural health midwife in a rural community in the in the Philippines were enjoined to share their perspectives in the sustainability of primary health care. The study utilized the critical research method. The critical research assumes that there are ‘dominated’ or ‘marginalized’ groups whose interests are not best served by existing societal structures. Their experiences highlighted that the challenges of their role include unkind and uncooperative patients, the lack of institutional support mechanisms and conflict of their roles with their family responsibilities. Their most revealing insight is the belief that primary health care is within their grasp. Finally, they believe that the burden to sustain primary health care rests on their shoulders alone. This study establishes that Multi-stakeholder participation is and Gender-sensitivity is integral to the sustainability of Primary Health Care. It also observed that the ingrained Expert-Novice or Top-down Management Culture and the marginalisation of BHWs within the system is a threat to PHC sustainability. This study also recommends to expand the study and to involve the local government units and academe in lobbying the integration of gender-sensitivity and multi-stake participatory approaches to health workforce policies. Finally, this study recognised that the CHWs’ role is indispensable to the sustainability of primary health care.

Keywords: community health workers, multi-stakeholder participation, sustainability, gender-sensitivity

Procedia PDF Downloads 477
6293 Unfolding Simulations with the Use of Socratic Questioning Increases Critical Thinking in Nursing Students

Authors: Martha Hough RN

Abstract:

Background: New nursing graduates lack the critical thinking skills required to provide safe nursing care. Critical thinking is essential in providing safe, competent, and skillful nursing interventions. Educational institutions must provide a curriculum that improves nursing students' critical thinking abilities. In addition, the recent pandemic resulted in nursing students who previously received in-person clinical but now most clinical has been converted to remote learning, increasing the use of simulations. Unfolding medium and high-fidelity simulations and Socratic questioning are used in many simulations debriefing sessions. Methodology: Google Scholar was researched with the keywords: critical thinking of nursing students with unfolding simulation, which resulted in 22,000 articles; three were used. A second search was implemented with critical thinking of nursing students Socratic questioning, which resulted in two articles being used. Conclusion: Unfolding simulations increase nursing students' critical thinking, especially during the briefing (pre-briefing and debriefing) phases, where most learning occurs. In addition, the use of Socratic questions during the briefing phases motivates other questions, helps the student analyze and critique their thinking, and assists educators in probing students' thinking, which further increases critical thinking.

Keywords: briefing, critical thinking, Socratic thinking, unfolding simulations

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6292 Protection of the Object of the Critical Infrastructure in the Czech Republic

Authors: Michaela Vašková

Abstract:

With the increasing dependence of countries on the critical infrastructure, it increases their vulnerability. Big threat is primarily in the human factor (personnel of the critical infrastructure) and in terrorist attacks. It emphasizes the development of methodology for searching of weak points and their subsequent elimination. This article discusses methods for the analysis of safety in the objects of critical infrastructure. It also contains proposal for methodology for training employees of security services in the objects of the critical infrastructure and developing scenarios of attacks on selected objects of the critical infrastructure.

Keywords: critical infrastructure, object of critical infrastructure, protection, safety, security, security audit

Procedia PDF Downloads 258
6291 Clinical Outcomes of Critically Ill Patients with Sepsis Receiving Extended and Standard Meropenem Infusion in Malaysian Hospitals

Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

Abstract:

Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

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6290 Analyzing and Mining Big Data in Health Industry Using Hortonworks

Authors: Sukhpreet Singh

Abstract:

Big Data may be coupled with new technologies to improve conversion rates in the healthcare sector (healthcare segment). A system that ensures the reliability of Big Data analytics will play a critical role in changing the way the health care sector functions nowadays. The study and analytics of Big Data can be used for tracking and managing population with electronic medical record (EMR) health care effectively and efficiently. This also plays a vital role in delivering preventive care. Health care will change a great deal as it becomes a data-driven industry. But the size of the data, the speed at which it’s growing, and the threat it could cause to individual privacy mean mastering it is one of biomedicine's most critical challenges. Hiding within this huge amount of data is the knowledge that could change the life of a patient. Health information that can be extracted from patient records is another rich resource of data. The research will explore how big data can enhance healthcare segment (HS) in countries. Additionally, the researcher will discuss the challenges associated with extensive data analysis utilizing map-reduce technology. The barriers to implementing big data analytics in the health business and big data analytics may elevate health care to a new extreme by improving patient care quality. In a nation like India, where the population is enormous, the medical system is very complex. Today, a sizable percentage of the expense and effort spent on medication research is due to failed formulations. Big Data can assist in reducing the cost and time required to bring innovative medications to market. Additionally, by using medical data learning at the early phases of drug development, researchers will tailor medicines to composite patient profiles.

Keywords: big data, electronic medical record, map-reduce, healthcare segment, analytics

Procedia PDF Downloads 114
6289 Critical Activity Effect on Project Duration in Precedence Diagram Method

Authors: Salman Ali Nisar, Koshi Suzuki

Abstract:

Precedence Diagram Method (PDM) with its additional relationships i.e., start-to-start, finish-to-finish, and start-to-finish, between activities provides more flexible schedule than traditional Critical Path Method (CPM). But, changing the duration of critical activities in PDM network will have anomalous effect on critical path. Researchers have proposed some classification of critical activity effects. In this paper, we do further study on classifications of critical activity effect and provide more information in detailed. Furthermore, we determine the maximum amount of time for each class of critical activity effect by which the project managers can control the dynamic feature (shortening/lengthening) of critical activities and project duration more efficiently.

Keywords: construction project management, critical path method, project scheduling, precedence diagram method

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6288 The Effect of Critical Activity on Critical Path and Project Duration in Precedence Diagram Method

Authors: J. Nisar, S. Halim

Abstract:

The additional relationships i.e., start-to-start, finish-to-finish, and start-to-finish, between activity in Precedence Diagram Method (PDM) provides a more flexible schedule than traditional Critical Path Method (CPM). But, changing the duration of critical activities in the PDM network will have an anomalous effect on the critical path and the project completion date. In this study, we classified the critical activities in two groups i.e., 1. activity on single critical path and 2. activity on multi-critical paths, and six classes i.e., normal, reverse, neutral, perverse, decrease-reverse and increase-normal, based on their effects on project duration in PDM. Furthermore, we determined the maximum float of time by which the duration each type of critical activities can be changed without effecting the project duration. This study would help the project manager to clearly understand the behavior of each critical activity on critical path, and he/she would be able to change the project duration by shortening or lengthening activities based on project budget and project deadline.

Keywords: construction management, critical path method, project scheduling network, precedence diagram method

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6287 Numerical Solution of 1-D Shallow Water Equations at Junction for Sub-Critical and Super-Critical Flow

Authors: Mohamed Elshobaki, Alessandro Valiani, Valerio Caleffi

Abstract:

In this paper, we solve 1-D shallow water equation for sub-critical and super-critical water flow at junction. The water flow at junction has been studied for the last 50 years from the physical-hydraulic point of views and for numerical computations need more attention. For numerical simulation, we need to establish an inner boundary condition at the junction to avoid an oscillation which rise from the waves interactions at the junction. Indeed, we introduce a new boundary condition at the junction based on the mass conservation, total head, and the admissible wave relations between the flow parameters in the three branches to predict the water depths and discharges at the junction. These boundary conditions are valid for sub-critical flow and super-critical flow.

Keywords: numerical simulation, junction flow, sub-critical flow, super-critical flow

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6286 Fathers’ Rights to Contact and Care: Moving Beyond the Adversarial Approach

Authors: Wesahl Domingo, Prinslean Mahery

Abstract:

Our paper focuses on the rights’ to contact and care of fathers in the heterosexual context, despite the reality of same sex parenting in South Africa. We argue that despite the new South African Children’s Act framework creating a shift from the idea of parental power over a child to the notion that parents have parental responsibilities and rights in respect of a child. This shift has however not fundamentally changed the constant battle that parents and other interested parties have over children. In most cases it is fathers who must battle to either maintain contact with their child/ren or fight to have care (which includes custody) of their child/ren. This is the case whether or not the father was married to the mother of the child in question. In part one of the paper, we deal with the historical development of rights to care and contact and describe the current system in the context of case law and legislation in South Africa. Part two provides a critical analysis of a few anthologies of “what fathers are complaining about.” In conclusion, in part three, we outline the way forward –“moving beyond the adversarial approach” through the “care of ethics approach.” So what is the care perspective? The care perspective is a relational ethic which views the primary moral concern as of creating and sustaining responsive connection to others. We apply the care of ethics approach to parenting plans and family law mediation in the context of fathers’ rights to care and contact. We argue by avoiding the adversarial system and engaging in a problem solving process focused on finding solutions for the future, divorcing parents can turn their attention to their children rather than battling each other.

Keywords: fathers' right to care, contact, custody, family law

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6285 The Application of the Security Audit Method on the Selected Objects of Critical Infrastructure

Authors: Michaela Vašková

Abstract:

The paper is focused on the application of the security audit method on the selected objects of the critical infrastructure. The emphasis is put on security audit method to find gaps in the critical infrastructure security. The theoretical part describes objects of the critical infrastructure. The practical part describes using the security audit method. The main emphasis was put on the protection of the critical infrastructure in the Czech Republic.

Keywords: crisis management, critical infrastructure, object of critical infrastructure, security audit, extraordinary event

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6284 Adoption of Lean Thinking and Service Improvement for Care Home Service

Authors: Chuang-Chun Chiou

Abstract:

Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: lean, service improvement, SERVQUAL, care home service

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6283 Evidence Based Practice for Oral Care in Children

Authors: T. Turan, Ç. Erdoğan

Abstract:

As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.

Keywords: evidence-based practice, oral care, nursing, children

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6282 Protective Custody in Child Protection: Reflection of Residential Care Workers in the Philippines

Authors: Hazel S. Cometa-Lamberte

Abstract:

This paper presents the residential care workers reflections in working with children who were under protective custody and placed in a residential care facility for children. Key informant interviews and focus group discussion were employed in this study to analyze the views of residential care workers on the programs and services and case management system in residential care for children. Results suggest that working in a residential care facility for children needs the interplay of both the worker’s personal and professional values, knowledge and skills in working with children. Analyzing the residential care workers experiences in handling children in residential care facilities is vital for the improvement of the policies, programs and services, the repertoire of techniques and facilitate the creation of a new social work practice framework/model in child protection specifically in residential care facilities.

Keywords: child protection, residential care, residential care workers, social workers

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6281 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

Abstract:

Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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6280 Critical Realism as a Bridge between Critical Pedagogy and Queer Theory

Authors: Mike Seal

Abstract:

This paper explores the traditions of critical and queer pedagogy, its intersections, tensions and paradoxes. Critical pedagogy, with a materialist realist ontology, and queer theory, which is often post-modern, post-structural and anti-essential, may not seem compatible. Similarly, there are tensions between activist orientations, often enacted through essential sexual identities, and a queer approach that questions such identities and subjectivities. It will argue that critical realism gives us a bridge between critical and queer pedagogy in preserving a realist materialist ontology, where economic forces are real, and independent of consciousness and hermeneutic constructions of them. At the same time, it offers an epistemology that does not necessitate a binary view of the roles of the oppressed, liberator, or even oppressor. It accepts that our knowledge is contingent, partial and contestable, but has the potential, and enough validity, to demand action and potentially inform the actions of others.

Keywords: critical pedagogy, queer pedagogy, critical realsim, heteronormativity

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6279 Improving Students' Critical Thinking in Understanding Reading Material Through Bloom's Critical Thinking Questioning Strategy in English for Specific Purposes (ESP) Class

Authors: Hevriani Sevrika Mayuasti

Abstract:

This research deals in improving college students’ critical thinking at English for Specific Purposes Subject. The strategy that is applied is Bloom’s Critical Thinking Questioning Strategy. The positive side of this strategy is that the given questions are developed based on Bloom’s taxonomy level. It is an action research because the researcher uses own class in doing this research. The processes of this research have been done from April to Mei 2014. There are two cycles and each cycle consists of two meetings. After doing the research, it is gotten that Bloom’s Critical Thinking Questioning Strategy improves college students’ critical thinking. It helps the students to build and elaborate their ideas. Hence, it increases students’ reading comprehension.

Keywords: critical thinking, blooms’ critical thinking, questioning, strategy

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6278 Creation of a Care Robot Impact Assessment

Authors: Eduard Fosch-Villaronga

Abstract:

This paper pioneers Care Robot Impact Assessment (CRIA), a methodology used to identify, analyze, mitigate and eliminate the risks posed by the insertion of non-medical personal care robots (PCR) in medical care facilities. Its precedent instruments (Privacy and Surveillance Impact Assessment (PIA and SIA)) fall behind in coping with robots. Indeed, personal care robots change dramatically how care is delivered. The paper presents a specific risk-sector methodology, identifies which robots are under its scope and presents some of the challenges introduced by these robots.

Keywords: ethics, impact assessment, law, personal care robots

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6277 Availability and Utilization of Health Care Facilities in Jalpaiguri Town

Authors: Sharmistha Mukherjee

Abstract:

Health care is the basic requirement for all. The prime question is who gets what, where and how? The unequal distribution of basic facilities do have a adverse effect on the users. The paper tries to examine health care in terms of available facilities, the health care need and how people perceive to it in a small town of Jalpaiguri in the midst of tea gardens in North Bengal. The morbidity pattern is also minutely observed with a section describing the organizational structure of health care keeping in mind the utilization.

Keywords: availability, distribution, health care, utilization

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6276 Promoting Critical Thinking in a Robotics Class

Authors: Ian D. Walker

Abstract:

This paper describes the creation and teaching of an undergraduate course aimed at promoting critical thinking among the students in the course. The class, Robots in Business and Society, taught at Clemson University, is open to all undergraduate students of any discipline. It is taught as part of Clemson’s online class program and is structured to promote critical thinking via a series of interactive discussion boards and assignments. Critical thinking is measured via pre- and post-testing using a benchmark standardized test. The paper will detail the class organization, and describe and discuss the results and lessons learned with respect to improvement of student critical thinking from three offerings of the class.

Keywords: critical thinking, pedagogy, robotics, undergraduate teaching

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6275 Application Potential of Selected Tools in Context of Critical Infrastructure Protection and Risk Analysis

Authors: Hromada Martin

Abstract:

Risk analysis is considered as a fundamental aspect relevant for ensuring the level of critical infrastructure protection, where the critical infrastructure is seen as system, asset or its part which is important for maintaining the vital societal functions. Article actually discusses and analyzes the potential application of selected tools of information support for the implementation and within the framework of risk analysis and critical infrastructure protection. Use of the information in relation to their risk analysis can be viewed as a form of simplifying the analytical process. It is clear that these instruments (information support) for these purposes are countless, so they were selected representatives who have already been applied in the selected area of critical infrastructure, or they can be used. All presented fact were the basis for critical infrastructure resilience evaluation methodology development.

Keywords: critical infrastructure, protection, resilience, risk analysis

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6274 The Implementation of a Nurse-Driven Palliative Care Trigger Tool

Authors: Sawyer Spurry

Abstract:

Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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6273 Alvaro Siza’s Design Strategy: An Insight into Critical Regionalism

Authors: Rahmatollah Amirjani

Abstract:

By the emergence of the debate over the failure of Regionalism in the late 1970s, Critical Regional­ism was introduced as a different way to respond to the state of architecture in the post-war era. Critical Regionalism is most often understood as a discourse that not only mediates the language of modern architecture with the local cultures but also revives the relation between architecture and spectator as indexed by capitalism. Since the inception of Critical Regionalism, a large number of architectural practices have emerged around the globe; however, the work of the well-known Portuguese architect, Álvaro Siza, is considered as a unique case amongst works associated with the discourse of Critical Regionalism. This paper intends to respond to a number of questions, including; what are the origins of Critical Regionalism? How does Siza’s design strategy correspond to the thematic of Critical Regionalism? How does Siza recover the relation between object and subject in most of his projects? Using Siza’s housing project for the Malagueira district in Évora, Portugal, this article will attempt to answer these questions, and highlight Alvaro Siza’s design procedure which goes beyond the existing discourse of Critical Regionalism and contributes to our understanding of this practice.

Keywords: Alvaro Siza, critical regionalism, Malagueira housing, placelessness

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