Search results for: medical staff

Authors: Luke Taylor, Samantha J. Hall, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman

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Medway School of Pharmacy, as part of an Equality Diversity and Inclusivity (EDI) initiative run by the University of Kent, decided to take steps to try and negate disparities in numeracy competencies within students undertaking the Master of Pharmacy degree in order to combat a trend in pharmacy students’ numerical abilities upon entry. This included a research driven project 1) to identify if pharmacy students are aware of weaknesses in their numeracy capabilities, and 2) recognise where their numeracy skillset is lacking. In addition to gaining this student perspective, a number of actions have been implemented to support students in improving their numeracy competencies. Reflective and quantitative analysis has shown promising improvements for the final year cohort of 2014/15 when compared to previous years. The method of involving student feedback into the structure of numeracy teaching/support has proven to be extremely beneficial to both students and teaching staff alike. Students have felt empowered and in control of their own learning requirements, leading to increased engagement and attainment. School teaching staff have received quality data to help improve existing initiatives and to innovate further in the area of numeracy teaching. In light of the recognised improvements, further actions are currently being trialled in the area of numeracy support. This involves utilising Virtual Learning Environment platforms to provide individualised support as a supplement to the increased numeracy mentoring (staff and peer) provided to students. Mentors who provide group or one-to-one sessions are now given significant levels of training in dealing with situations that commonly arise from mentoring schemes. They are also provided with continued support throughout the life of their degree. Following results from this study, Medway School of Pharmacy hopes to drive increasing numeracy standards within Pharmacy (primarily through championing peer mentoring) as well as other healthcare professions including Midwifery and Nursing.

Keywords: attainment, ethnicity, numeracy, pharmacy, support

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Authors: Samuel Oye Bandele

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A policy is a system of principles to guide activities and strategic decisions of an organisation in order to achieve stated objectives and meeting expected outcomes. A Computer Based Test (CBT) policy is therefore a statement of intent to drive the CBT programmes, and should be implemented as a procedure or protocol. Policies are hence generally adopted by an organization or a nation. The concern here, in this paper, is the consideration and analysis of issues that are significant to evolving the acceptable policy that will drive the new CBT innovation in Nigeria. Public examinations and internal examinations in higher educational institutions in Nigeria are gradually making a radical shift from Paper Based or Paper-Pencil to Computer-Based Testing. The need to make an objective and empirical analysis of Policy issues relating to CBT became expedient. The following are some of the issues on CBT evolution in Nigeria that were identified as requiring policy backing. Prominent among them are requirements for establishing CBT centres, purpose of CBT, types and acquisition of CBT equipment, qualifications of staff: professional, technical and regular, security plans and curbing of cheating during examinations, among others. The descriptive research design was employed based on a population consisting of Principal Officers (Policymakers), Staff (Teaching and non-Teaching-Policy implementors), and CBT staff ( Technical and Professional- Policy supports) and candidates (internal and external). A fifty-item researcher-constructed questionnaire on policy issues was employed to collect data from 600 subjects drawn from higher institutions in South West Nigeria, using the purposive and stratified random sampling techniques. Data collected were analysed using descriptive (frequency counts, means and standard deviation) and inferential (t-test, ANOVA, regression and Factor analysis) techniques. Findings from this study showed, among others, that the factor loadings had significantly weights on the organizational and National policy issues on CBT innovation in Nigeria.

Keywords: computer-based testing, examination, innovation, paper-based testing, paper pencil based testing, policy issues

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Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

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Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

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Authors: Asima Mehaboob Khan, Rizwan Taj

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Purpose: This study aims to estimate the knowledge, attitude and practices of medical ethics among young healthcare professionals. Method: A qualitative descriptive study was conducted among young healthcare professionals from both public and private sector medical institutions. Using the convenience sampling technique, 272 healthcare professionals participated in this study. A pre-structured modified questionnaire was used to collect the data. Descriptive analyses were executed for each variable. Result: About 76.47% of healthcare professional considers the importance of adequate knowledge of medical ethics, and 82.24% declared lecture, seminars and clinical discussion as the source of their medical knowledge of biomedical ethics. About 42.44% of healthcare professionals exhibited a negative attitude toward medical ethics, 57.72% showed a mildly positive attitude, whereas 1.10% and 0.74% indicated a moderately positive attitude and a highly positive attitude towards medical ethics. Similarly, the level of practice according to medical ethics is also very poor among young healthcare professionals. 34.56% of healthcare professionals deviated from medical ethics during their clinical practices, whereas 0.74% showed a good level of medical practice according to medical ethics. Conclusion: It is concluded in this research study that young healthcare professionals have adequate theoretical knowledge of medical ethics but are not properly trained to perform their clinical practices according to the guidelines of medical ethics. Furthermore, their professional attitude is poorly developed to maintain medical ethics during their clinical practices.

Keywords: knowledge, attitude, practices, medical ethics

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Authors: Mahmoud Tarek Mohamed Hammad

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Despite the importance of the role and efforts made by the universities of the Kingdom of Saudi Arabia in reviving and preserving heritage architecture as an important cultural heritage in the Kingdom, The idea revolves around restoration and conservation processes and neglects the architectural heritage values, whose content can be used in sustainable contemporary architectural works. Educational values based on heritage architecture and how to integrate with the contemporary requirements were investigated in this research. For this purpose, by understanding the heritage architectural values as well as educational, academic process, the researcher presented an educational model of questionnaire forms for architecture students and the staff at the Architecture Department at Al-Baha University as a case study that serves the aims of the research. The results of the research show that heritage values especially those interview results are considered as a positive indicator of the importance of these values. The students and the staff need both to gain an understanding of heritage values as well as an understanding of theories of incorporating those values into the design process of contemporary local architecture. The research concludes that a correct understanding of the heritage values, its performance, and its reintegration with modern architecture technology should be focused on architectural education.

Keywords: heritage architecture, academic work, heritage values, sustainable contemporary local architectural

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Authors: Chen Xiatong

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The study aims to explore the interrelationship between corporate governance factors and firm performance in Mainland China using a mixed-method approach. To clarify the current effectiveness of corporate governance, uncover the complex interrelationships between governance factors and firm performance, and enhance understanding of corporate governance strategies in Mainland China. The research involves quantitative methods like statistical analysis of governance factors and firm performance data, as well as qualitative approaches including policy research, case studies, and interviews with staff members. The study aims to reveal the current effectiveness of corporate governance in Mainland China, identify complex interrelationships between governance factors and firm performance, and provide suggestions for companies to enhance their governance practices. The research contributes to enriching the literature on corporate governance by providing insights into the effectiveness of governance practices in Mainland China and offering suggestions for improvement. Quantitative data will be gathered through surveys and sampling methods, focusing on governance factors and firm performance indicators. Qualitative data will be collected through policy research, case studies, and interviews with staff members. Quantitative data will be analyzed using statistical, mathematical, and computational techniques. Qualitative data will be analyzed through thematic analysis and interpretation of policy documents, case study findings, and interview responses. The study addresses the effectiveness of corporate governance in Mainland China, the interrelationship between governance factors and firm performance, and staff members' perceptions of corporate governance strategies. The research aims to enhance understanding of corporate governance effectiveness, enrich the literature on governance practices, and contribute to the field of business management and human resources management in Mainland China.

Keywords: corporate governance, business management, human resources management, board of directors

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Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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Authors: Z. Razi, S. M. J. Mortazavi, N. Shokrpour, Z. Shayan, F. Amiri

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Long-term exposure to low doses of ionizing radiation occurs in radiation health care workplaces. Although doses in health professions are generally very low, there are still matters of concern. The radiation safety program promotes occupational radiation safety through accurate and reliable monitoring of radiation workers in order to effectively manage radiation protection. To achieve this goal, it has become mandatory to implement health examination periodically. As a result, based on the hematological alterations, working populations with a common occupational radiation history are screened. This paper calls into question the effectiveness of blood component analysis as a screening program which is mandatory for medical radiation workers in some countries. This study details the distribution and trends of changes in blood components, including white blood cells (WBCs), red blood cells (RBCs) and platelets as well as received cumulative doses from occupational radiation exposure. This study was conducted among 199 participants and 100 control subjects at the medical imaging departments at the central hospital of Shiraz University of Medical Sciences during the years 2006–2010. Descriptive and analytical statistics, considering the P-value<0.05 as statistically significance was used for data analysis. The results of this study show that there is no significant difference between the radiation workers and controls regarding WBCs and platelet count during 4 years. Also, we have found no statistically significant difference between the two groups with respect to RBCs. Besides, no statistically significant difference was observed with respect to RBCs with regards to gender, which has been analyzed separately because of the lower reference range for normal RBCs levels in women compared to men and. Moreover, the findings confirm that in a separate evaluation between WBCs count and the personnel’s working experience and their annual exposure dose, results showed no linear correlation between the three variables. Since the hematological findings were within the range of control levels, it can be concluded that the radiation dosage (which was not more than 7.58 mSv in this study) had been too small to stimulate any quantifiable change in medical radiation worker’s blood count. Thus, use of more accurate method for screening program based on the working profile of the radiation workers and their accumulated dose is suggested. In addition, complexity of radiation-induced functions and the influence of various factors on blood count alteration should be taken into account.

Keywords: blood cell count, mandatory testing, occupational exposure, radiation

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Authors: Sreejith Jayachandran, Mojtaba Ghods, Morteza Mohammadzaheri

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The modern busy world is running behind new embedded technologies based on computers and software; meanwhile, some people forget to do their health condition and regular medical check-ups. Some of them postpone medical check-ups due to a lack of time and convenience, while others skip these regular evaluations and medical examinations due to huge medical bills and hospital expenses. Engineers and medical experts have come together to give birth to a new device in the telemonitoring system capable of monitoring, checking, and evaluating the health status of the human body remotely through the internet for the needs of all kinds of people. The remote health monitoring device is a microcontroller-based embedded unit. Various types of sensors in this device are connected to the human body, and with the help of an Arduino UNO board, the required analogue data is collected from the sensors. The microcontroller on the Arduino board processes the analogue data collected in this way into digital data and transfers that information to the cloud, and stores it there, and the processed digital data is instantly displayed through the LCD attached to the machine. By accessing the cloud storage with a username and password, the concerned person’s health care teams/doctors and other health staff can collect this data for the assessment and follow-up of that patient. Besides that, the family members/guardians can use and evaluate this data for awareness of the patient's current health status. Moreover, the system is connected to a Global Positioning System (GPS) module. In emergencies, the concerned team can position the patient or the person with this device. The setup continuously evaluates and transfers the data to the cloud, and also the user can prefix a normal value range for the evaluation. For example, the blood pressure normal value is universally prefixed between 80/120 mmHg. Similarly, the RHMS is also allowed to fix the range of values referred to as normal coefficients. This IoT-based miniature system (11×10×10) cm³ with a low weight of 500 gr only consumes 10 mW. This smart monitoring system is manufactured with 100 GBP, which can be used not only for health systems, it can be used for numerous other uses including aerospace and transportation sections.

Keywords: embedded technology, telemonitoring system, microcontroller, Arduino UNO, cloud storage, global positioning system, remote health monitoring system, alert system

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Authors: Yuan-Hsiang Chang, Zhong-Xian Peng, Li-Der Jeng

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Music has always been an integral part of human’s daily lives. But, for the most people, reading musical score and turning it into melody is not easy. This study aims to develop an Automatic music score recognition system using digital image processing, which can be used to read and analyze musical score images automatically. The technical approaches included: (1) staff region segmentation; (2) image preprocessing; (3) note recognition; and (4) accidental and rest recognition. Digital image processing techniques (e.g., horizontal /vertical projections, connected component labeling, morphological processing, template matching, etc.) were applied according to musical notes, accidents, and rests in staff notations. Preliminary results showed that our system could achieve detection and recognition rates of 96.3% and 91.7%, respectively. In conclusion, we presented an effective automated musical score recognition system that could be integrated in a system with a media player to play music/songs given input images of musical score. Ultimately, this system could also be incorporated in applications for mobile devices as a learning tool, such that a music player could learn to play music/songs.

Keywords: connected component labeling, image processing, morphological processing, optical musical recognition

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Authors: Rania Albsoul, Muhammad Ahmed Alshyyab, Baraa Ayed Al Odat, Nermeen Borhan Al Dwekat, Batool Emad Al-masri, Fatima Abdulsattar Alkubaisi, Salsabil Awni Flefil, Majd Hussein Al-Khawaldeh, Ragad Ayman Sa’ed, Maha Waleed Abu Ajamieh, Gerard Fitzgerald

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Purpose: The purpose of this paper is to explore the perceptions of operating room staff towards the use of the World Health Organization Surgical Safety Checklist in a tertiary hospital in Jordan. Design/methodology/approach: This was a qualitative descriptive study. Semi-structured interviews were conducted with a purposeful sample of 21 healthcare staff employed in the operating room (nurses, residents, surgeons, and anaesthesiologists). The interviews were conducted in the period from October to December 2021. Thematic analysis was used to analyse the data. Findings: Three main themes emerged from data analysis, namely compliance with the surgical safety checklist, the impact of the surgical safety checklist, and barriers and facilitators to the use of the surgical safety checklist. The use of the checklist was seen as enabling staff to communicate effectively and thus accomplish patient safety and positive outcomes. The perceived barriers to compliance included excessive workload, congestion, and lack of training and awareness. Enhanced training and education were thought to improve the utilization of the surgical safety checklist and help enhance awareness about its importance. Originality/value: While steps to utilize the surgical safety checklist by the operation room personnel may seem simple, the quality of its administration is not necessarily robust. There are several challenges to consistent, complete, and effective administration of the surgical safety checklist by the surgical team members. Healthcare managers must employ interventions to eliminate barriers to and offer facilitators of adherence to the application of the surgical safety checklist, therefore promoting quality healthcare and patient safety.

Keywords: patient safety, surgical safety checklist, compliance, utility, operating room, quality healthcare, communication, teamwork

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Authors: Kafeero Frank

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This study aimed at developing a frame work for open source software adoption in an institution of higher learning in Uganda, with the case of KIU as a study area. There were mainly four research questions based on; individual staff interaction with open source software forum, perceived FOSS characteristics, organizational characteristics and external characteristics as factors that affect open source software adoption. The researcher used causal-correlation research design to study effects of these variables on open source software adoption. A quantitative approach was used in this study with self-administered questionnaire on a purposively and randomly sampled sample of university ICT staff. Resultant data was analyzed using means, correlation coefficients and multivariate multiple regression analysis as statistical tools. The study reveals that individual staff interaction with open source software forum and perceived FOSS characteristics were the primary factors that significantly affect FOSS adoption while organizational and external factors were secondary with no significant effect but significant correlation to open source software adoption. It was concluded that for effective open source software adoption to occur there must be more effort on primary factors with subsequent reinforcement of secondary factors to fulfill the primary factors and adoption of open source software. Lastly recommendations were made in line with conclusions for coming up with Kyambogo University frame work for open source software adoption in institutions of higher learning. Areas of further research recommended include; Stakeholders’ analysis of open source software adoption in Uganda; Challenges and way forward. Evaluation of Kyambogo University frame work for open source software adoption in institutions of higher learning. Framework development for cloud computing adoption in Ugandan universities. Framework for FOSS development in Uganda IT industry

Keywords: open source software., organisational characteristics, external characteristics, cloud computing adoption

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Authors: Ashfaq M. Naikwadi

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Decided cases of medical negligence, mostly are not settled in the lower courts. Majority of them reach up to the apex courts. This is mostly due to different interpretations of the term medical negligence. After studying various cases of medical negligence it is found that in most of the cases the doctors/hospitals are not held liable. There are different interpretations of law concerning medical services. Globally the principles deciding medical negligence are same, viz. Legal duty of care - breach of that duty - direct causation resulting in damages. Since ordinary negligence is not punishable by law, doctors/hospitals have defenses to save themselves from liability. Complaints of negligence come to the courts whose judges mostly are not oriented with medical services or health sciences. Matters of medical negligence are decided on the basic principles of reasonableness and prudence or by relying on the expert’s opinion. Deciding reasonableness or prudence is a complex issue in case of medical services. Again expert opinion is also questionable as an expert in case of medical negligence is appointed from the same field and same faculty. There is a chance of favoritism to the doctor/hospital. The concept of vicarious liability is not widely applied to in many of the medical negligence cases. Established cases used as precedents were studied to understand the basic principles in deciding medical negligence. This paper evaluates the present criteria in interpreting medical negligence and concludes with suggesting reforms required to be made in deciding matters of medical negligence under the consumer laws.

Keywords: consumer, doctors, laws, medical negligence

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Authors: Biruk Hundito Lodebo

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The main purpose of this study was to investigate the problems of sports commitment and athlete satisfaction of Oromia league football clubs in the West, East and Horro Guduru wollega zones. The descriptive survey method was designed and approached as a quantitative method. The data was collected by questionnaires. The research data was collected from sports commitment and athlete satisfaction variables. The target population of this study was (3x30=90) and the researcher selected by using purposive sampling techniques. The data were analysed by SPSS Software (Version 20). Such as mean standard deviation, one-way ANOVA and correlational analysis. The level of significance is 0.05 alpha level. The researchers' hypothesis of this study was: (1) There is no significant difference between sports commitments and player satisfaction indices in all selected Oromia league football wollega zones. (2)There is no significant difference between sports commitments and player satisfaction indices in all selected Oromia league football wollega zones.(3)There is no correlation between the variables of sports commitments and player satisfaction indices in all selected Oromia league football wollega zones. Finally, the study findings indicated that: (a) There is no significant difference between sports commitment and athlete satisfaction of Oromia league football clubs. (b) There is no significant difference between player age and sports commitment in Oromia league football clubs in the West, East and Horro Guduru wollega zones. (c) There is no significant difference between player age and athlete satisfaction in Oromia league football clubs in the West, East and Horro Guduru wollege zones. Based on the research findings the following recommendations were forwarded: The club management and players should be made a positive linkage and improvement between sports commitments and player satisfaction, All clubs management staff and coaching staff should promote Sports commitment and player satisfaction. Workshops and short-term training can be held for all of sports management staff and players.

Keywords: sports commetmnet, Athet satisfaction, football, Oromia league

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Authors: Murtala Aminu, Salisu Adamu Aliero, Adamu Muhammed

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Records are a vital asset in ensuring that the institution is governed effectively and efficiently, and is accountable to its staff, students and the community that it serves. The major purpose of this study was to assess record management of the registry department of Kebbi state University of science and technology Aliero. To be able to achieve this objective, research questions were formulated and answers obtained, which centered on records creation, record management policy, challenges facing records management. The review of related literature revealed that there is need for records to be properly managed and in doing so there is need for good records management policy that clearly spells out the various programs required for effective records management. Survey research method was used involving questionnaire, and observation. The findings revealed that the registry department of the University still has a long way to go with respect to day-today records management. The study recommended provision for adequate, modern, safe and functional storage facilities, sufficient and regular funding, recruitment of trained personnel, on the job training for existing staff, computerization of all units records, and uninterrupted power supply to all parts of the unit as a means of ensuring proper records management.

Keywords: records, management, records management policy, registry

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Authors: Narottam Puri, Gurvinder Kaur

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

Keywords: NABH, reaccreditation, quality assurance, quality indicators

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Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

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Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

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Authors: Nassali Celine Lindah

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The study sought to find out how public accountability is a challenge to sustainable development in Uganda. The study was guided by the following set of objectives included establishing the challenges of Public accountability, the importance of accountability in Uganda, and the possible solutions to the problems identified in the study. In order to ensure proper accountability there should be proper control of resources, specifically the control of both public revenue and expenditures. Stakeholders should also be involved in the accountability process. Accountability can reduce corruption and other abuses, assure compliance with standards and procedures, and improve performance and organizational learning. The study involved qualitative and quantitative data collection techniques. A sample of 20 respondents from various districts/towns was used using both technical staff and non-technical staff members. The study utilized secondary and primary data, which was obtained using interviews and observations. The study reached a conclusion that the major challenges of Public accountability in Uganda are poor leadership, poor resource management, unethical behavior by the government officials and political involvement, among others. The study also recommended that the policymakers should design relevant guidelines/policies to help promote the process of public accountability in Uganda like prosecution and convictions, strengthen public expenditure management benchmarking and performance measurements, among others.

Keywords: accountability, sustainability, government activities, government sector

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Authors: Gholam Reza Mirzaei, Mehran Roost

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This research was conducted with the aim of predicting the relationship between coronavirus anxiety and psychological hardiness in employees working at Shahid Beheshti Hospital in Shiraz. The current research design was descriptive and correlational. The statistical population of the research consisted of all the employees of Shahid Beheshti Hospital in Shiraz in 2021. From among the statistical population, 220 individuals were selected and studied based on available sampling. To collect data, Kobasa's psychological hardiness questionnaire and coronavirus anxiety questionnaire were used. After collecting the data, the scores of the participants were analyzed using Pearson's correlation coefficient multiple regression analysis and SPSS-24 statistical software. The results of Pearson's correlation coefficient showed that there is a significant negative correlation between psychological hardiness and its components (challenge, commitment, and control) with coronavirus anxiety; also, psychological hardiness with a beta coefficient of 0.20 could predict coronavirus anxiety in hospital employees. Based on the results, plans can be made to enhance psychological hardiness through educational workshops to relieve the anxiety of the healthcare staff.

Keywords: the corona virus, commitment, hospital employees, psychological hardiness

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Authors: Ilse Kreme

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To the best of this author’s knowledge, no studies have been identified on the connection between a refusal to engage in health-protective behaviors and a basic understanding of viral biology among community college students, faculty, and staff during the COVID-19 pandemic. Lack of scientific knowledge could prevent understanding of why these behaviors are important to prevent the community spread of COVID-19, even when they are not shown to offer much individual protection. In this study, a possible correlation was examined between a basic knowledge level of viral disease that comes from having taken a college biology course and disease perceptions of COVID-19. In particular, disease risk perception, disease severity percept and mask-wearing behaviors were examined as they correlated with having taken an undergraduate biology course. The effect of covariates of age, gender, and education level were investigated along with the main dependent variables. A representative sample of the population included students, faculty, and staff at Paradise Valley Community College (PVCC) in Phoenix, Arizona. Participants were recruited by an email sent to all students, faculty, and staff at PVCC using an all-college email distribution. Disease risk and severity perception were assessed with the Brief Illness Perception Questionnaire 5 (BIP-Q5), which was modified to include questions measuring participant age, education level, and whether they took or ever took a college biology course. Two additional questions measured compliance of willingness to wear a face mask. The results showed an effect of gender on mask-wearing behavior and a correlation between having taken a biology course and disease severity perception. No differences were seen in mask-wearing behavior and disease risk perception as a result of having taken a biology course. These findings suggest that taking an undergraduate biology course leads to a greater awareness of COVID-19 disease severity through an understanding of the basic biological principles of viral disease transmission. The results can be used to modify existing health education strategies. Further research is needed on how to best reach target audiences in all education brackets.

Keywords: COVID-19, education, gender, mask wearing, disease risk perception, disease severity perception

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Authors: Rasheed A. Saliu, Sunday E. Ogundipe, Oluwaseun A. Adefila

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Information and Communication Technology (ICT) in recent time has transformed the means by which we inform ourselves, with world events and areas of personal interests, and further our learning. Today, for many, books and journals are no longer the first or primary source of information or learning. We now regularly rely on images, video, animations and sound to acquire information and to learn. Increased and improved access to the internet has accelerated this phenomenon. We now acquire and access information in ways fundamentally different from the pre-ICT era. But to what extent is academic staff in colleges of education, having access to and the utilising of ICT devices in their lecture deliveries especially in School of Science and Vocational and Technical? The main focus of this paper is to proffer solution to this salient question. It is essentially an empirical study carried out in five colleges of education in south-west zone of Nigeria. The target population was the academic staff in the selected institution. A total number of 150 male and female lecturers were contacted for the study. The main instrument was questionnaire. The finding reveals that male lecturers are much more ICT inclined than women folk in the academics. Some recommendations were made to endear academics to utilizing ICT at their disposal to foster qualitative delivery in this digital era.

Keywords: education, gender, ICT, Nigeria

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Authors: Jiani Gao, Qingping Luo, Xinlei Fang

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In order to try to achieve better rights and interests for both doctors and patients in the new medical environment, the paper will focus on the renewal and development of medical buildings. In today's highly developed society, many factors have a profound guiding significance for the development of medical buildings. By doing social research, the paper has found that these factors come from all aspects. These factors include the optimization of traditional medical model, rapid alternation of medical technology and equipment, the reform of the social, medical security system, changes in the age structure of the population, the birth of intelligent medical care under the Internet, and the deepening of the concept of green sustainable building development, etc. The purpose of this paper is to capture sensitively these various factors that may affect the evolution of medical buildings in the context of the current era, and to put forward, by using an adaptable development strategy, some feasible suggestions on the design of medical buildings when facing these changes and challenges. Specifically speaking, the adaptable development strategy includes some basic principles and methods, such as using modular design, adopting scalable streamline, selecting a long-span structural system and using replaceable materials and components, etc.

Keywords: medical architecture, adaptable development, medical model, space design

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Authors: F. DelGaudio, H. Gill

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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

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Authors: Jonathan E. Oghenekohwo

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The return to scale constitutes a significant investment index in the determination of the quantum of resources that is deployed in investment decision on worker’s continuing professional development. Such investment decision is always predicted on the expected outcomes to the individual, institution and the society in context. Several investments in the development of human capacity on the job have been made, but the return to the scale of such seems not to have been correlated positively with the quantum of resources invested in terms of productivity and performance among workers in many universities. This paper thus found out that, despite the commitment and policy instrument to avail workers the right of continuing professional development, the multiplier effects are not evident in diligence, commitment, honesty, dedication, productivity and improved performance on the job among most administrative staff in Nigerian Universities This author, therefore concludes that, given the policy on the right of workers to get trained on-the job, the outcomes of such training must reflect on the overall performance indices, otherwise, institutions should carry out a forensic analysis of the types of continuing professional development programmes that workers participate in, whether or not, they are consistent with the vision and mission of the institutions in terms of economies of scale of workers professional development to the individual, institution and the nation in context.

Keywords: continuing, professional development, economies of scale, worker’s education, administrative staff

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Authors: Paulette Henry

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If Caribbean Universities wish to remain sustainable in the global education market they must meet the new demands of the 21st Centuries learners. This means preparing the teaching and learning environment with the human and material and resources so that the University can blossom out into the entrepreneurial University. The entrepreneurial University prepares the learner to become a global citizen, one who is innovative and a critical thinker and has the competencies to create jobs. Entrepreneurship education provides more equitable access to university education building capacity for the local and global economy. The entrepreneurial thinking, the mindset, must therefore be among academic and support staff as well as students. In developing countries where resources are scarce, Universities are grappling with a myriad of financial and non-financial issues. These include increasing costs, Union demands for increased remuneration for staff and reduced subvention from governments which has become the norm. In addition, there is the political pressure against increasing tuition fees and the perceptions on the moral responsibilities of universities in national development. The question is how do small universities carve out their niche, meet both political and consumer demands for a high quality, low lost education, fulfil their development mandate and still remain not only viable but competitive. Themes which are central to this discourse on the transitions necessary for the entrepreneurial university are leadership, governance and staff well-being. This paper therefore presents a case study of a Caribbean University to show how transformational leadership and the change management framework propels change towards an entrepreneurial institution seeking to have a competitive advantage despite its low resourced context. Important to this discourse are the transformational approaches used by the University to prepare staff to move from their traditional psyche to embracing an entrepreneurial mindset whilst equipping students within the same mode to become work ready and creative global citizens. Using the mixed methods approach, opinions were garnered from both members of the University community as well as external stakeholder groups on their perception of the role of the University in the business arena and as a primary stakeholder in national development. One of the critical concepts emanating from the discourse was the need to change the mindset of the those in university governance as well as how national stakeholders engage the university. This paper shows how multiple non-financial factors can contribute to change. A combination of transformational and servant leadership, strengthened institutional structures and developing new ones, rebuilding institutional trust and pride have been among the strategies employed within the change management framework. The university is no longer limited by borders but through international linkages has transcended into a transnational stakeholder.

Keywords: competitiveness, context, entrepreneurial, leadership

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Authors: Nicolas Koslover, Tamara Levene

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Aims: Tonsilitis is one of the most common presentations to the A+E department. We aimed to assess whether patients presenting with tonsilitis are being managed in-line with current guidance. We then set out to educate A+E staff about tonsilitis management and then assessed for improvement in management. Methods: All patients presenting to A+E in one fortnight with a documented diagnosis of tonsilitis were included. We reviewed the notes to assess the choice of treatment in each case and whether a clinical score (CENTOR or FEVERPain score) was used to guide choice of treatment (in accordance with NICE guideline [NG84]). We designed and delivered an educational intervention for A+E staff covering tonsilitis guidelines. The audit was repeated two weeks later. Results: Over the study period, 49 patients were included; only 35% (n=17) had either a clinical score documented or had all components of a score recorded. In total, 39% (n=19) were treated with antibiotics. Of these, 63% (n=12) should not have been prescribed an antibiotic and 37% (n=7) were prescribed an inappropriate antibiotic. At re-audit, (n=50 cases), 58% (n=29) had a clinical score documented and 28% (n=14) were treated with antibiotics. Of these, 29% (n=4) should not have been prescribed antibiotics and 21% (n=3) were prescribed an inappropriate antibiotic. Thus, after this teaching session, there was a significant improvement in antibiotic prescribing practices (63% vs. 29%, p=0.026). Conclusions: A+E assessment and management of tonsilitis frequently deviated from guidelines, but a single teaching session vastly improved clinical scoring and antibiotic prescribing practices.

Keywords: tonsilitis, education, emergency medicine, ENT

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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Authors: Lucas B. Naves, Maria José Abreu

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Reprocessing single-use device has attracted interesting on the medical environment over the last decades. The reprocessing technique was sought in order to reduce the cost of purchasing the new medical device, which can achieve almost double of the price of the reprocessed product. In this manuscript, we have done a literature review, aiming the reuse of medical device that was firstly designed for single use only, but has become, more and more, effective on its reprocessing procedure. We also show the regulation, the countries which allows this procedure, the classification of these device and also the most important issue concerning the re-utilization of medical device, how to minimizing the risk of gram positive and negative bacteria, avoid cross-contamination, hepatitis B (HBV), and C (HCV) virus, and also human immunodeficiency virus (HIV).

Keywords: reusing, reprocessing, single-use medical device, HIV, hepatitis B and C

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Authors: Ayse Collins

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The Agenda 2030 puts Higher Education Institutions (HEIs) in the situation where they should emphasize ways to promote sustainability accordingly. However, it is still unclear: a) how sustainability is understood, and b) which actions have been taken in both discourse and practice by HEIs regarding the three pillars of sustainability, society, environment, and economy. There are models of sustainable universities developed by different authors from different countries; For Example, The Global Reporting Initiative (GRI) methodology which offers a variety of indicators to diagnose performance. However, these models have never been developed for universities in particular. Any model, in this sense, cannot be completed adequately without defining the appropriate tools to measure, analyze and control the performance of initiatives. There is a need to conduct researches in different universities from different countries to understand where we stand in terms of sustainable higher education. Therefore, this study aims at exploring the actions taken by a university in Ankara, Turkey, since Agenda 2030 should consider localizing its objectives and targets according to a certain geography. This university just announced 2021-2022 as “Sustainability Year.” Therefore, this research is a multi-methodology longitudinal study and uses the theoretical framework of the organization and transition management (TM). It is designed to examine the activities as being strategic, tactical, operational, and reflexive in nature and covers the six main aspects: academic community, administrative staff, operations and services, teaching, research, and extension. The preliminary research will answer the role of the top university governance, perception of the stakeholders (students, instructors, administrative and support staff) regarding sustainability, and the level of achievement at the mid-evaluation and final, end of year evaluation. TM Theory is a multi-scale, multi-actor, process-oriented approach with the analytical framework to explore and promote change in social systems. Therefore, the stages and respective methodology for collecting data in this research is: Pre-development Stage: a) semi-structured interviews with university governance, c) open-ended survey with faculty, students, and administrative staff d) Semi-structured interviews with support staff, and e) analysis of current secondary data for sustainability. Take-off Stage: a) semi-structured interviews with university governance, faculty, students, administrative and support staff, b) analysis of secondary data. Breakthrough stabilization a) survey with all stakeholders at the university, b) secondary data analysis by using selected indicators for the first sustainability report for universities The findings from the predevelopment stage highlight how stakeholders, coming from different faculties, different disciplines with different identities and characteristics, face the sustainability challenge differently. Though similar sustainable development goals ((social, environmental, and economic) are set in the institution, there are differences across disciplines and among different stakeholders, which need to be considered to reach the optimum goal. It is believed that the results will help changes in HEIs organizational culture to embed sustainability values in their strategic planning, academic and managerial work by putting enough time and resources to be successful in coping with sustainability.

Keywords: higher education, sustainability, sustainability auditing, transition management

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